diclofenac potassium 50 MG Powder for Oral Solution

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diclofenac potassium

RxCUI: 859063

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.
0.5%
Plan Coverage
23
Plans Covering
T3
Avg Tier
0%
Prior Auth Required

What the CMS Formulary Data Shows for diclofenac potassium 50 MG Powder for Oral Solution

Per the CMS 2026 Part D formulary file, diclofenac potassium 50 MG Powder for Oral Solution (RxNorm concept RXCUI 859063, generic name diclofenac potassium) appears on 3 distinct formulary files spanning 23 Medicare Part D plan offerings - 0.5% of enrollable Part D products, selective placement; verify formulary inclusion before enrolling. Tier placement ranges from Tier 2 to Tier 4, with a cross-plan average of Tier 3.

Real-world access to diclofenac potassium 50 MG Powder for Oral Solution depends on utilization management as much as tier placement: 0% of covering formularies require prior authorization. 66.7% require step therapy. 100% apply quantity limits.

Historical spending context from the CMS Medicare Part D Drug Spending Dashboard shows 147,980 Part D beneficiaries filled diclofenac potassium 50 MG Powder for Oral Solution in 2023, with total plan-and-beneficiary spending of $43,042,044 and an average per-beneficiary annual cost of $290.86. The plan-by-plan detail below lists exactly which PDP and MA-PD contracts carry diclofenac potassium 50 MG Powder for Oral Solution today.

Coverage Details

Formularies covering
3
Plans covering
23
Coverage rate
0.5%
Tier range
Tier 2 – Tier 4
Average tier
Tier 3, Preferred Brand

Restrictions

Prior authorization required
0% of formularies
Step therapy required
66.7% of formularies
Quantity limits
100% of formularies

2023 Medicare Spending

Beneficiaries
147,980
Total spending
$43,042,044
Avg per beneficiary
$290.86

Tier Distribution Across Plans

1 plans
Tier 2, Generic
14 plans
Tier 3, Preferred Brand
8 plans
Tier 4, Non-Preferred

Medicare Advantage Plans (MA-PD) Covering diclofenac potassium 50 MG Powder for Oral Solution

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

Plan Insurer Tier PA Premium States
Healthy Mississippi Premier Advantage (HMO-POS) Healthy Mississippi, Inc. T2 No $0 MS
Select Health Medicare Essential (HMO) SELECTHEALTH, INC. T3 No $0 UT
Select Health Medicare Essential (HMO) SELECTHEALTH, INC. T3 No $0 NV
Select Health Medicare Dual (HMO D-SNP) SELECTHEALTH, INC. T3 No $0 UT
Select Health Medicare Essential (HMO) SELECTHEALTH, INC. T3 No $0 UT
Select Health Medicare + Kroger (HMO) SELECTHEALTH, INC. T3 No $0 NV
Select Health Medicare + Kroger (HMO) SELECTHEALTH, INC. T3 No $0 UT
Select Health Medicare Essential (HMO) SELECTHEALTH, INC. T3 No $0 CO
Select Health Medicare Essential (HMO) SELECTHEALTH, INC. T3 No $0 CO
Select Health Medicare + Kroger (HMO) SELECTHEALTH, INC. T3 No $0 CO
Select Health Medicare Flex (HMO) SELECTHEALTH, INC. T3 No $0 CO
Select Health Medicare + Kroger (HMO) SELECTHEALTH, INC. T3 No $0 CO
Select Health Medicare Active (HMO) SELECTHEALTH, INC. T3 No $0 CO
Select Health Medicare Dual (HMO D-SNP) SELECTHEALTH, INC. T3 No $0 NV
Select Health Medicare Wellness (HMO) SELECTHEALTH, INC. T3 No $0 NV
Network Health Select (PPO) NETWORK HEALTH INSURANCE CORPORATION T4 No $0 WI
Network Health Go (PPO) NETWORK HEALTH INSURANCE CORPORATION T4 No $0 WI
Network Health Anywhere (PPO) NETWORK HEALTH INSURANCE CORPORATION T4 No $0 WI
Network Health Choice (PPO) NETWORK HEALTH INSURANCE CORPORATION T4 No $0 WI
Network Health Zero (PPO) NETWORK HEALTH INSURANCE CORPORATION T4 No $0 WI
Network Health Cares (PPO D-SNP) NETWORK HEALTH INSURANCE CORPORATION T4 No $21.10 WI
Network Health PlusRx (PPO) NETWORK HEALTH INSURANCE CORPORATION T4 No $38.60 WI
Network Health PremierRx (PPO) NETWORK HEALTH INSURANCE CORPORATION T4 No $92.80 WI

Frequently Asked Questions

Is diclofenac potassium 50 MG Powder for Oral Solution covered by Medicare Part D?

Yes, diclofenac potassium 50 MG Powder for Oral Solution is covered by 23 Medicare Part D plans (0.5% of all Part D formularies).

What tier is diclofenac potassium 50 MG Powder for Oral Solution on Medicare Part D plans?

diclofenac potassium 50 MG Powder for Oral Solution averages Tier 3 across Part D plans, ranging from Tier 2 to Tier 4.

Does diclofenac potassium 50 MG Powder for Oral Solution require prior authorization?

0% of Part D formularies require prior authorization for diclofenac potassium 50 MG Powder for Oral Solution. Step therapy: 66.7%. Quantity limits: 100%.

How much does Medicare spend on diclofenac potassium 50 MG Powder for Oral Solution?

In 2023, total Medicare Part D spending on diclofenac potassium 50 MG Powder for Oral Solution was $43,042,044, covering 147,980 beneficiaries. The average spend per beneficiary was $290.86.

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