diclofenac sodium 20 MG/ML Topical Solution
diclofenac sodium
RxCUI: 1487074
What the CMS Formulary Data Shows for diclofenac sodium 20 MG/ML Topical Solution
Per the CMS 2026 Part D formulary file, diclofenac sodium 20 MG/ML Topical Solution (RxNorm concept RXCUI 1487074, generic name diclofenac sodium) appears on 82 distinct formulary files spanning 497 Medicare Part D plan offerings - 9.8% 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 3.9.
Real-world access to diclofenac sodium 20 MG/ML Topical Solution depends on utilization management as much as tier placement: 72% of covering formularies require prior authorization. 0% require step therapy. 100% apply quantity limits.
Historical spending context from the CMS Medicare Part D Drug Spending Dashboard shows 3,196,668 Part D beneficiaries filled diclofenac sodium 20 MG/ML Topical Solution in 2023, with total plan-and-beneficiary spending of $396,080,706 and an average per-beneficiary annual cost of $123.90. The plan-by-plan detail below lists exactly which PDP and MA-PD contracts carry diclofenac sodium 20 MG/ML Topical Solution today.
Coverage Details
- Formularies covering
- 82
- Plans covering
- 497
- Coverage rate
- 9.8%
- Tier range
- Tier 1 – Tier 5
- Average tier
- Tier 4, Non-Preferred
Restrictions
- Prior authorization required
- 72% of formularies
- Step therapy required
- 0% of formularies
- Quantity limits
- 100% of formularies
2023 Medicare Spending
- Beneficiaries
- 3,196,668
- Total spending
- $396,080,706
- Avg per beneficiary
- $123.90
Tier Distribution Across Plans
Medicare Advantage Plans (MA-PD) Covering diclofenac sodium 20 MG/ML Topical Solution
100 Medicare Advantage plans with Part D drug coverage include this drug.
| Plan | Insurer | Tier | PA | Premium | States |
|---|---|---|---|---|---|
| ElderServe MAP (HMO D-SNP) | ELDERSERVE HEALTH, INC. | T1 | No | $0 | NY |
| Cooperative Advantage (HMO D-SNP) | GROUP HEALTH COOPERATIVE OF EAU CLAIRE | T1 | No | $0 | WI |
| Longevity Health Plan (PPO I-SNP) | LONGEVITY HEALTH PLAN OF NEW JERSEY INSURANCE COMP | T1 | No | $0 | NJ |
| Upper Peninsula Health Plan MI Coordinated Health (HMO D-SNP) | UPPER PENINSULA HEALTH PLAN, LLC | T1 | No | $0 | MI |
| CareSource Dual Advantage (HMO D-SNP) | CARESOURCE GEORGIA CO. | T1 | No | $0 | GA |
| HAP CareSource MI Coordinated Health (HMO D-SNP) | HAP CARESOURCE | T1 | No | $0 | MI |
| Elevate Medicare Choice (HMO D-SNP) | DENVER HEALTH MEDICAL PLAN, INC. | T1 | Yes | $0 | CO |
| AllCare Advantage Redwood Rx (HMO D-SNP) | ALLCARE HEALTH PLAN, INC. | T1 | Yes | $0 | OR |
| PrimeWest Senior Health Complete (HMO D-SNP) | PRIMEWEST RURAL MN HEALTH CARE ACCESS INITIATIVE | T1 | Yes | $0 | MN |
| Prime Health Complete (HMO D-SNP) | PRIMEWEST RURAL MN HEALTH CARE ACCESS INITIATIVE | T1 | Yes | $0 | MN |
| Alterwood Advantage Dual Secure (HMO D-SNP) | ALTERWOOD ADVANTAGE, INC. | T1 | Yes | $0 | MD |
| Nascentia Dual Advantage (HMO D-SNP) | VISITING NURSE ASSOCIATION OF CENTRAL NEW YORK | T1 | Yes | $0 | NY |
| Abilis Health Community (HMO I-SNP) | SIGNATURE ADVANTAGE, LLC | T1 | Yes | $0 | KY, TN |
| Arkansas Integrated Providers (AIP) Dual Advantage (HMO D-SNP) | ARKANSAS SUPERIOR SELECT, INC. | T1 | Yes | $0 | AR |
| CalOptima Health OneCare Complete (HMO D-SNP) | ORANGE COUNTY HEALTH AUTHORITY | T1 | Yes | $0 | CA |
| Longevity Health Plan (HMO I-SNP) | LONGEVITY HEALTH PLAN OF FLORIDA, INC. | T1 | No | $4.80 | FL |
| Gold Dialysis & Kidney Complete (HMO-POS C-SNP) | GOLD KIDNEY OF FLORIDA INC | T1 | Yes | $4.80 | FL |
| Texas Independence Health Plan, Inc. (HMO I-SNP) | TEXAS INDEPENDENCE HEALTH PLAN, INC. | T1 | Yes | $4.80 | TX |
| Texas Independence Community Plan (HMO I-SNP) | TEXAS INDEPENDENCE HEALTH PLAN, INC. | T1 | Yes | $4.80 | TX |
| Longevity Health Plan (HMO I-SNP) | LONGEVITY HEALTH PLAN OF MICHIGAN, INC. | T1 | No | $8.80 | MI |
| Tribute Select (HMO-POS I-SNP) | ARKANSAS SUPERIOR SELECT, INC. | T1 | Yes | $8.90 | AR |
| ATRIO Special Needs Plan (HMO D-SNP) | ATRIO HEALTH PLANS | T1 | Yes | $10.50 | OR |
| ATRIO Special Needs Plan (HMO D-SNP) | ATRIO HEALTH PLANS | T1 | Yes | $10.50 | OR |
| Longevity Health Plan (HMO I-SNP) | LONGEVITY HEALTH PLAN OF ILLINOIS, INC. | T1 | No | $15.20 | IL |
| Gold Dialysis & Kidney Complete (HMO-POS C-SNP) | GOLD KIDNEY OF ARIZONA | T1 | Yes | $17.00 | AZ |
| WellSense Added Value (HMO) | BOSTON MEDICAL CENTER HEALTH PLAN, INC. | T1 | No | $21.70 | NH |
| Alterwood Advantage Dual Value (HMO D-SNP) | ALTERWOOD ADVANTAGE, INC. | T1 | Yes | $31.20 | MD |
| Valor Health Plan (HMO I-SNP) | TSG GUARD, INC. | T1 | Yes | $31.40 | OH |
| WV Senior Advantage (HMO I-SNP) | WEST VIRGINIA SENIOR ADVANTAGE, INC. | T1 | Yes | $32.70 | WV |
| Longevity Health Plan (HMO I-SNP) | LONGEVITY HEALTH PLAN OF COLORADO, INC. | T1 | No | $35.20 | CO |
| Abilis Health (HMO I-SNP) | SIGNATURE ADVANTAGE, LLC | T1 | Yes | $35.90 | KY, TN |
| Longevity Health Plan (HMO I-SNP) | LONGEVITY HEALTH PLAN OF NORTH CAROLINA, INC. | T1 | No | $36.20 | NC |
| CommuniCare Advantage ISNP (HMO I-SNP) | OH CHS SNP INC. | T1 | Yes | $38.40 | IN, MD, OH |
| Longevity Health Plan (PPO I-SNP) | LONGEVITY HEALTH PLAN OF NEW JERSEY INSURANCE COMP | T1 | No | $40.00 | NJ |
| ElderServe Star (HMO I-SNP) | ELDERSERVE HEALTH, INC. | T1 | No | $58.80 | NY |
| Longevity Health Plan (HMO I-SNP) | LONGEVITY HEALTH PLAN OF NEW YORK, INC. | T1 | No | $58.80 | NY |
| Nascentia Skilled Nursing Facility (HMO I-SNP) | VISITING NURSE ASSOCIATION OF CENTRAL NEW YORK | T1 | Yes | $58.80 | NY |
| HealthSpring Preferred (HMO) | BRAVO HEALTH PENNSYLVANIA, INC. | T4 | Yes | $0 | AZ |
| HealthSpring Alliance (HMO) | BRAVO HEALTH PENNSYLVANIA, INC. | T4 | Yes | $0 | AZ |
| HealthSpring Preferred Savings (HMO) | BRAVO HEALTH PENNSYLVANIA, INC. | T4 | Yes | $0 | AZ |
| HealthSpring Preferred Full Savings (HMO) | BRAVO HEALTH PENNSYLVANIA, INC. | T4 | Yes | $0 | AZ |
| HealthSpring Preferred GA (HMO) | HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC. | T4 | Yes | $0 | GA |
| HealthSpring Preferred (HMO) | HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC. | T4 | Yes | $0 | GA |
| HealthSpring Preferred (HMO) | HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC. | T4 | Yes | $0 | GA |
| HealthSpring Preferred (HMO) | HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC. | T4 | Yes | $0 | GA |
| HealthSpring Preferred (HMO) | HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC. | T4 | Yes | $0 | GA |
| HealthSpring Preferred (HMO) | HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC. | T4 | Yes | $0 | GA |
| HealthSpring Preferred (HMO) | HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC. | T4 | Yes | $0 | GA |
| HealthSpring Preferred Savings (HMO) | HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC. | T4 | Yes | $0 | GA |
| HealthSpring Preferred Savings (HMO) | HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC. | T4 | Yes | $0 | GA |
Frequently Asked Questions
Is diclofenac sodium 20 MG/ML Topical Solution covered by Medicare Part D?
Yes, diclofenac sodium 20 MG/ML Topical Solution is covered by 497 Medicare Part D plans (9.8% of all Part D formularies).
What tier is diclofenac sodium 20 MG/ML Topical Solution on Medicare Part D plans?
diclofenac sodium 20 MG/ML Topical Solution averages Tier 3.9 across Part D plans, ranging from Tier 1 to Tier 5.
Does diclofenac sodium 20 MG/ML Topical Solution require prior authorization?
72% of Part D formularies require prior authorization for diclofenac sodium 20 MG/ML Topical Solution. Step therapy: 0%. Quantity limits: 100%.
How much does Medicare spend on diclofenac sodium 20 MG/ML Topical Solution?
In 2023, total Medicare Part D spending on diclofenac sodium 20 MG/ML Topical Solution was $396,080,706, covering 3,196,668 beneficiaries. The average spend per beneficiary was $123.90.
Read our methodology - how this data is sourced, computed, and verified.