dofetilide 0.25 MG Oral Capsule [Tikosyn]
dofetilide
RxCUI: 284405
What the CMS Formulary Data Shows for dofetilide 0.25 MG Oral Capsule [Tikosyn]
Per the CMS 2026 Part D formulary file, dofetilide 0.25 MG Oral Capsule [Tikosyn] (RxNorm concept RXCUI 284405, generic name dofetilide) appears on 2 distinct formulary files spanning 8 Medicare Part D plan offerings - 0.2% of enrollable Part D products, selective placement; verify formulary inclusion before enrolling. Tier placement ranges from Tier 1 to Tier 4, with a cross-plan average of Tier 2.5.
Real-world access to dofetilide 0.25 MG Oral Capsule [Tikosyn] 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 65,815 Part D beneficiaries filled dofetilide 0.25 MG Oral Capsule [Tikosyn] in 2023, with total plan-and-beneficiary spending of $81,106,334 and an average per-beneficiary annual cost of $1,232.34. The plan-by-plan detail below lists exactly which PDP and MA-PD contracts carry dofetilide 0.25 MG Oral Capsule [Tikosyn] today.
Coverage Details
- Formularies covering
- 2
- Plans covering
- 8
- Coverage rate
- 0.2%
- Tier range
- Tier 1 – Tier 4
- Average tier
- Tier 3, Preferred Brand
Restrictions
- Prior authorization required
- 0% of formularies
- Step therapy required
- 0% of formularies
- Quantity limits
- 0% of formularies
2023 Medicare Spending
- Beneficiaries
- 65,815
- Total spending
- $81,106,334
- Avg per beneficiary
- $1,232.34
Tier Distribution Across Plans
Medicare Advantage Plans (MA-PD) Covering dofetilide 0.25 MG Oral Capsule [Tikosyn]
8 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 |
| Óptimo Plus (PPO) | TRIPLE S ADVANTAGE, INC. | T4 | No | $0 | PR |
| Contigo Plus (HMO C-SNP) | TRIPLE S ADVANTAGE, INC. | T4 | No | $0 | PR |
| Brillante (HMO-POS) | TRIPLE S ADVANTAGE, INC. | T4 | No | $0 | PR |
| Enlace Plus (HMO) | TRIPLE S ADVANTAGE, INC. | T4 | No | $0 | PR |
| ContigoEnMente (HMO C-SNP) | TRIPLE S ADVANTAGE, INC. | T4 | No | $0 | PR |
| Ahorro Plus (HMO) | TRIPLE S ADVANTAGE, INC. | T4 | No | $0 | PR |
Frequently Asked Questions
Is dofetilide 0.25 MG Oral Capsule [Tikosyn] covered by Medicare Part D?
Yes, dofetilide 0.25 MG Oral Capsule [Tikosyn] is covered by 8 Medicare Part D plans (0.2% of all Part D formularies).
What tier is dofetilide 0.25 MG Oral Capsule [Tikosyn] on Medicare Part D plans?
dofetilide 0.25 MG Oral Capsule [Tikosyn] averages Tier 2.5 across Part D plans, ranging from Tier 1 to Tier 4.
Does dofetilide 0.25 MG Oral Capsule [Tikosyn] require prior authorization?
0% of Part D formularies require prior authorization for dofetilide 0.25 MG Oral Capsule [Tikosyn]. Step therapy: 0%. Quantity limits: 0%.
How much does Medicare spend on dofetilide 0.25 MG Oral Capsule [Tikosyn]?
In 2023, total Medicare Part D spending on dofetilide 0.25 MG Oral Capsule [Tikosyn] was $81,106,334, covering 65,815 beneficiaries. The average spend per beneficiary was $1,232.34.
Read our methodology - how this data is sourced, computed, and verified.