Medicare Part D coverage · doxepin hydrochloride · RxCUI 1000093

doxepin hydrochloride 50 MG/ML Topical Cream [Prudoxin]

Per the CMS 2026 Part D formulary file, doxepin hydrochloride 50 MG/ML Topical Cream [Prudoxin] is covered by 6 Medicare Part D plans (0.1% of enrollable products), averaging Tier 2.5, with prior authorization required on 50% of covering formularies.

0.1%
Plan coverage
6
Plans covering
T2.5
Avg tier
50%
Prior auth required

Verify with CMS →

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.

What the CMS Formulary Data Shows for doxepin hydrochloride 50 MG/ML Topical Cream [Prudoxin]

Per the CMS 2026 Part D formulary file, doxepin hydrochloride 50 MG/ML Topical Cream [Prudoxin] (RxNorm concept RXCUI 1000093, generic name doxepin hydrochloride) appears on 2 distinct formulary files spanning 6 Medicare Part D plan offerings - 0.1% 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 doxepin hydrochloride 50 MG/ML Topical Cream [Prudoxin] depends on utilization management as much as tier placement: 50% 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 276,316 Part D beneficiaries filled doxepin hydrochloride 50 MG/ML Topical Cream [Prudoxin] in 2023, with total plan-and-beneficiary spending of $78,711,446 and an average per-beneficiary annual cost of $284.86. The plan-by-plan detail below lists exactly which PDP and MA-PD contracts carry doxepin hydrochloride 50 MG/ML Topical Cream [Prudoxin] today.

Coverage Details

Formularies covering
2
Plans covering
6
Coverage rate
0.1%
Tier range
Tier 1 – Tier 4
Average tier
Tier 3, Preferred Brand

Restrictions

Prior authorization required
50% of formularies
Step therapy required
0% of formularies
Quantity limits
0% of formularies

2023 Medicare Spending

Beneficiaries
276,316
Total spending
$78,711,446
Avg per beneficiary
$284.86

Tier Distribution Across Plans

2 plans
Tier 1, Preferred Generic
4 plans
Tier 4, Non-Preferred

Medicare Advantage Plans (MA-PD) Covering doxepin hydrochloride 50 MG/ML Topical Cream [Prudoxin]

6 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 Yes $0 NY
Hamaspik Medicare Select (HMO D-SNP) Hamaspik, Inc. T1 Yes $34.50 NY
Presbyterian Senior Care Plan 2 with Rx (HMO) Presbyterian Health Plan T4 No $0 NM
Presbyterian Dual Plus (HMO D-SNP) Presbyterian Health Plan T4 No $0 NM
Presbyterian Senior Care Extra Health Plan with Rx (HMO) Presbyterian Health Plan T4 No $0 NM
Presbyterian Senior Care Plan 3 with Rx (HMO) Presbyterian Health Plan T4 No $65.80 NM

Frequently Asked Questions

Is doxepin hydrochloride 50 MG/ML Topical Cream [Prudoxin] covered by Medicare Part D?

Yes, doxepin hydrochloride 50 MG/ML Topical Cream [Prudoxin] is covered by 6 Medicare Part D plans (0.1% of all Part D formularies).

What tier is doxepin hydrochloride 50 MG/ML Topical Cream [Prudoxin] on Medicare Part D plans?

doxepin hydrochloride 50 MG/ML Topical Cream [Prudoxin] averages Tier 2.5 across Part D plans, ranging from Tier 1 to Tier 4.

Does doxepin hydrochloride 50 MG/ML Topical Cream [Prudoxin] require prior authorization?

50% of Part D formularies require prior authorization for doxepin hydrochloride 50 MG/ML Topical Cream [Prudoxin]. Step therapy: 0%. Quantity limits: 0%.

How much does Medicare spend on doxepin hydrochloride 50 MG/ML Topical Cream [Prudoxin]?

In 2023, total Medicare Part D spending on doxepin hydrochloride 50 MG/ML Topical Cream [Prudoxin] was $78,711,446, covering 276,316 beneficiaries. The average spend per beneficiary was $284.86.

Read our methodology - how this data is sourced, computed, and verified.

Nationwide similar Part D drugs

Data-derived peers across the CMS Part D formulary extract: nearest average tier placement and nearest prior-authorization rate. Not therapeutic alternatives or same-generic strengths.

Closest average formulary tier

Similar prior-authorization rate

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