delgocitinib 20 MG/ML Topical Cream [Anzupgo]

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delgocitinib

RxCUI: 2721172

Important: Drug coverage and costs vary by plan and location. Verify coverage directly with your Medicare plan before filling a prescription. This is informational data only and should not replace advice from your healthcare provider or pharmacist.
3.8%
Plan Coverage
193
Plans Covering
T4.1
Avg Tier
85.7%
Prior Auth Required

What the CMS Formulary Data Shows for delgocitinib 20 MG/ML Topical Cream [Anzupgo]

Per the CMS 2026 Part D formulary file, delgocitinib 20 MG/ML Topical Cream [Anzupgo] (RxNorm concept RXCUI 2721172, generic name delgocitinib) appears on 14 distinct formulary files spanning 193 Medicare Part D plan offerings - 3.8% of enrollable Part D products, selective placement; verify formulary inclusion before enrolling. Tier placement ranges from Tier 1 to Tier 5, with a cross-plan average of Tier 4.1.

Real-world access to delgocitinib 20 MG/ML Topical Cream [Anzupgo] depends on utilization management as much as tier placement: 85.7% of covering formularies require prior authorization. 0% require step therapy. 85.7% apply quantity limits.

Medicare Part D spending dashboard figures are not published for this drug. The plan-by-plan detail below lists exactly which PDP and MA-PD contracts carry delgocitinib 20 MG/ML Topical Cream [Anzupgo] today.

Coverage Details

Formularies covering
14
Plans covering
193
Coverage rate
3.8%
Tier range
Tier 1 – Tier 5
Average tier
Tier 4, Non-Preferred

Restrictions

Prior authorization required
85.7% of formularies
Step therapy required
0% of formularies
Quantity limits
85.7% of formularies

Tier Distribution Across Plans

3 plans
Tier 1, Preferred Generic
97 plans
Tier 5, Specialty

Medicare Advantage Plans (MA-PD) Covering delgocitinib 20 MG/ML Topical Cream [Anzupgo]

100 Medicare Advantage plans with Part D drug coverage include this drug.

Plan Insurer Tier PA Premium States
NaviCare (HMO D-SNP) FALLON COMMUNITY HEALTH PLAN T1 Yes $0 MA
Mass General Brigham SCO (HMO D-SNP) MASS GENERAL BRIGHAM HEALTH PLAN, INC T1 Yes $0 MA
Mass General Brigham One Care (HMO D-SNP) MASS GENERAL BRIGHAM HEALTH PLAN, INC T1 Yes $0 MA
Community Blue Medicare HMO Signature (HMO) Highmark Western and Northeastern New York Inc. T5 Yes $0 NY
Community Blue Medicare HMO Merit (HMO) Highmark Western and Northeastern New York Inc. T5 Yes $0 NY
Community Blue Medicare PPO Signature (PPO) HIGHMARK SENIOR HEALTH COMPANY T5 Yes $0 PA
Complete Blue PPO Signature (PPO) HIGHMARK SENIOR HEALTH COMPANY T5 Yes $0 PA
Community Blue Medicare Plus PPO Signature (PPO) HIGHMARK SENIOR HEALTH COMPANY T5 Yes $0 PA
Complete Blue PPO Signature (PPO) HIGHMARK SENIOR HEALTH COMPANY T5 Yes $0 PA
Complete Blue PPO Merit (PPO) HIGHMARK SENIOR HEALTH COMPANY T5 Yes $0 PA
Complete Blue PPO Signature (PPO) HIGHMARK SENIOR HEALTH COMPANY T5 Yes $0 PA
Complete Blue PPO Distinct (PPO) HIGHMARK SENIOR HEALTH COMPANY T5 Yes $0 PA
Community Blue Medicare Plus PPO Signature (PPO) HIGHMARK SENIOR HEALTH COMPANY T5 Yes $0 PA
Complete Blue Plus PPO Merit (PPO) HIGHMARK SENIOR HEALTH COMPANY T5 Yes $0 PA
Community Blue Medicare PPO Signature (PPO) HIGHMARK SENIOR HEALTH COMPANY T5 Yes $0 PA
Complete Blue PPO Merit (PPO) HIGHMARK SENIOR HEALTH COMPANY T5 Yes $0 PA
Community Blue Medicare HMO Signature (HMO) HIGHMARK CHOICE COMPANY T5 Yes $0 PA
Security Blue HMO-POS ValueRx (HMO-POS) HIGHMARK CHOICE COMPANY T5 Yes $0 PA
Community Blue Medicare HMO Signature (HMO) HIGHMARK CHOICE COMPANY T5 Yes $0 PA
Together Blue Medicare HMO Signature (HMO) HIGHMARK CHOICE COMPANY T5 Yes $0 PA
Community Blue Medicare HMO Distinct (HMO) HIGHMARK CHOICE COMPANY T5 Yes $0 PA
Complete Blue HMO Distinct (HMO) HIGHMARK CHOICE COMPANY T5 Yes $0 PA
Complete Blue PPO Distinct (PPO) HIGHMARK SENIOR SOLUTIONS COMPANY T5 Yes $0 WV
Complete Blue PPO Signature (PPO) HIGHMARK SENIOR SOLUTIONS COMPANY T5 Yes $0 WV
Complete Blue PPO Signature (PPO) HIGHMARK SENIOR SOLUTIONS COMPANY T5 Yes $0 WV
Complete Blue PPO Merit (PPO) HIGHMARK SENIOR SOLUTIONS COMPANY T5 Yes $0 WV
Complete Blue PPO Signature (PPO) HIGHMARK BCBSD INC. T5 Yes $0 DE
Fallon Medicare Plus Orange (HMO) FALLON COMMUNITY HEALTH PLAN T5 Yes $0 MA
UPMC for Life HMO Premier Rx (HMO) UPMC HEALTH PLAN, INC. T5 Yes $0 PA
UPMC for Life Complete Care (HMO D-SNP) UPMC FOR YOU, INC T5 Yes $0 PA
UPMC for Life Complete Care (HMO D-SNP) UPMC FOR YOU, INC T5 Yes $0 PA
UPMC for Life PPO Premier Rx (PPO) UPMC HEALTH NETWORK, INC. T5 Yes $0 PA
UPMC for Life PPO Premier Rx (PPO) UPMC HEALTH NETWORK, INC. T5 Yes $0 PA
UPMC for Life PPO Essential Care Rx (PPO) UPMC HEALTH NETWORK, INC. T5 Yes $0 PA
UPMC for Life Complete Care (HMO D-SNP) UPMC HEALTH COVERAGE, INC. T5 Yes $0 PA
Kaiser Permanente Senior Advantage LA, Orange Co. (HMO) KAISER FOUNDATION HP, INC. T5 No $0 CA
Kaiser Permanente Senior Advantage Enhanced Solano (HMO) KAISER FOUNDATION HP, INC. T5 No $0 CA
Kaiser Permanente Senior Advantage Inland Empire (HMO) KAISER FOUNDATION HP, INC. T5 No $0 CA
Kaiser Permanente Sr Adv Enhanced Marin San Mateo (HMO) KAISER FOUNDATION HP, INC. T5 No $0 CA
Kaiser Permanente Senior Advantage Ventura (HMO) KAISER FOUNDATION HP, INC. T5 No $0 CA
Kaiser Permanente Senior Advantage Enhanced Kern (HMO) KAISER FOUNDATION HP, INC. T5 No $0 CA
Kaiser Permanente Senior Advantage Basic Kern (HMO) KAISER FOUNDATION HP, INC. T5 No $0 CA
Kaiser Permanente Senior Advantage San Diego (HMO) KAISER FOUNDATION HP, INC. T5 No $0 CA
Kaiser Permanente Sr Adv Enhanced Santa Clara (HMO) KAISER FOUNDATION HP, INC. T5 No $0 CA
Kaiser Permanente Senior Advantage Enhanced Stanis (HMO) KAISER FOUNDATION HP, INC. T5 No $0 CA
Kaiser Permanente Senior Advantage Basic Stanis (HMO) KAISER FOUNDATION HP, INC. T5 No $0 CA
Kaiser Permanente Senior Advantage Basic SnJoaq (HMO) KAISER FOUNDATION HP, INC. T5 No $0 CA
Kaiser Permanente Senior Advantage Basic Fresno (HMO) KAISER FOUNDATION HP, INC. T5 No $0 CA
Kaiser Permanente Sr Advantage Basic Sac., Sonoma (HMO) KAISER FOUNDATION HP, INC. T5 No $0 CA
Kaiser Permanente Senior Advantage Santa Cruz (HMO) KAISER FOUNDATION HP, INC. T5 No $0 CA

Frequently Asked Questions

Is delgocitinib 20 MG/ML Topical Cream [Anzupgo] covered by Medicare Part D?

Yes, delgocitinib 20 MG/ML Topical Cream [Anzupgo] is covered by 193 Medicare Part D plans (3.8% of all Part D formularies).

What tier is delgocitinib 20 MG/ML Topical Cream [Anzupgo] on Medicare Part D plans?

delgocitinib 20 MG/ML Topical Cream [Anzupgo] averages Tier 4.1 across Part D plans, ranging from Tier 1 to Tier 5.

Does delgocitinib 20 MG/ML Topical Cream [Anzupgo] require prior authorization?

85.7% of Part D formularies require prior authorization for delgocitinib 20 MG/ML Topical Cream [Anzupgo]. Step therapy: 0%. Quantity limits: 85.7%.

Data sourced from the Centers for Medicare & Medicaid Services (CMS). See our methodology for details. Retrieved and formatted by PlainMedicare Editorial