difluprednate 0.5 MG/ML Ophthalmic Suspension [Durezol]
difluprednate
RxCUI: 804547
What the CMS Formulary Data Shows for difluprednate 0.5 MG/ML Ophthalmic Suspension [Durezol]
Per the CMS 2026 Part D formulary file, difluprednate 0.5 MG/ML Ophthalmic Suspension [Durezol] (RxNorm concept RXCUI 804547, generic name difluprednate) appears on 2 distinct formulary files spanning 18 Medicare Part D plan offerings - 0.4% of enrollable Part D products, selective placement; verify formulary inclusion before enrolling. Tier placement ranges from Tier 1 to Tier 3, with a cross-plan average of Tier 2.
Real-world access to difluprednate 0.5 MG/ML Ophthalmic Suspension [Durezol] depends on utilization management as much as tier placement: 0% of covering formularies require prior authorization. 0% require step therapy. 0% apply quantity limits.
Historical spending context from the CMS Medicare Part D Drug Spending Dashboard shows 69,636 Part D beneficiaries filled difluprednate 0.5 MG/ML Ophthalmic Suspension [Durezol] in 2023, with total plan-and-beneficiary spending of $21,536,113 and an average per-beneficiary annual cost of $309.27. The plan-by-plan detail below lists exactly which PDP and MA-PD contracts carry difluprednate 0.5 MG/ML Ophthalmic Suspension [Durezol] today.
Coverage Details
- Formularies covering
- 2
- Plans covering
- 18
- Coverage rate
- 0.4%
- Tier range
- Tier 1 – Tier 3
- Average tier
- Tier 2, Generic
Restrictions
- Prior authorization required
- 0% of formularies
- Step therapy required
- 0% of formularies
- Quantity limits
- 0% of formularies
2023 Medicare Spending
- Beneficiaries
- 69,636
- Total spending
- $21,536,113
- Avg per beneficiary
- $309.27
Tier Distribution Across Plans
Medicare Advantage Plans (MA-PD) Covering difluprednate 0.5 MG/ML Ophthalmic Suspension [Durezol]
18 Medicare Advantage plans with Part D drug coverage include this drug.
| Plan | Insurer | Tier | PA | Premium | States |
|---|---|---|---|---|---|
| Hamaspik Medicare Choice (HMO D-SNP) | HAMASPIK, INC. | T1 | No | $0 | NY |
| Hamaspik Medicare Select (HMO D-SNP) | HAMASPIK, INC. | T1 | No | $34.50 | NY |
| MMM Supremo (HMO C-SNP) | MMM HEALTHCARE, LLC | T3 | No | $0 | PR |
| MMM Diamante Platino (HMO D-SNP) | MMM HEALTHCARE, LLC | T3 | No | $0 | PR |
| MMM Unico (HMO-POS) | MMM HEALTHCARE, LLC | T3 | No | $0 | PR |
| MMM Elite (HMO-POS) | MMM HEALTHCARE, LLC | T3 | No | $0 | PR |
| MMM Deluxe (HMO-POS) | MMM HEALTHCARE, LLC | T3 | No | $0 | PR |
| MMM Dorado Platino (HMO D-SNP) | MMM HEALTHCARE, LLC | T3 | No | $0 | PR |
| PMC Premier Platino (HMO D-SNP) | MMM HEALTHCARE, LLC | T3 | No | $0 | PR |
| PMC Max (HMO-POS) | MMM HEALTHCARE, LLC | T3 | No | $0 | PR |
| MMM Plenitud (HMO-POS) | MMM HEALTHCARE, LLC | T3 | No | $0 | PR |
| MMM Valioso (HMO-POS) | MMM HEALTHCARE, LLC | T3 | No | $0 | PR |
| MMM Combo Platino (HMO D-SNP) | MMM HEALTHCARE, LLC | T3 | No | $0 | PR |
| MMM Flexi Platino (HMO D-SNP) | MMM HEALTHCARE, LLC | T3 | No | $0 | PR |
| MMM Grandioso (HMO-POS) | MMM HEALTHCARE, LLC | T3 | No | $0 | PR |
| MMM Mega Flex (HMO-POS) | MMM HEALTHCARE, LLC | T3 | No | $0 | PR |
| MMM Relax Platino (HMO D-SNP) | MMM HEALTHCARE, LLC | T3 | No | $0 | PR |
| MMM Balance (HMO-POS) | MMM HEALTHCARE, LLC | T3 | No | $0 | PR |
Frequently Asked Questions
Is difluprednate 0.5 MG/ML Ophthalmic Suspension [Durezol] covered by Medicare Part D?
Yes, difluprednate 0.5 MG/ML Ophthalmic Suspension [Durezol] is covered by 18 Medicare Part D plans (0.4% of all Part D formularies).
What tier is difluprednate 0.5 MG/ML Ophthalmic Suspension [Durezol] on Medicare Part D plans?
difluprednate 0.5 MG/ML Ophthalmic Suspension [Durezol] averages Tier 2 across Part D plans, ranging from Tier 1 to Tier 3.
Does difluprednate 0.5 MG/ML Ophthalmic Suspension [Durezol] require prior authorization?
0% of Part D formularies require prior authorization for difluprednate 0.5 MG/ML Ophthalmic Suspension [Durezol]. Step therapy: 0%. Quantity limits: 0%.
How much does Medicare spend on difluprednate 0.5 MG/ML Ophthalmic Suspension [Durezol]?
In 2023, total Medicare Part D spending on difluprednate 0.5 MG/ML Ophthalmic Suspension [Durezol] was $21,536,113, covering 69,636 beneficiaries. The average spend per beneficiary was $309.27.
Read our methodology - how this data is sourced, computed, and verified.