droxidopa 100 MG Oral Capsule [Northera]
droxidopa
RxCUI: 1490032
What the CMS Formulary Data Shows for droxidopa 100 MG Oral Capsule [Northera]
Per the CMS 2026 Part D formulary file, droxidopa 100 MG Oral Capsule [Northera] (RxNorm concept RXCUI 1490032, generic name droxidopa) appears on 1 distinct formulary file spanning 2 Medicare Part D plan offerings - 0% of enrollable Part D products, selective placement; verify formulary inclusion before enrolling. Tier placement ranges from Tier 1 to Tier 1, with a cross-plan average of Tier 1.
Real-world access to droxidopa 100 MG Oral Capsule [Northera] depends on utilization management as much as tier placement: 100% 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 5,473 Part D beneficiaries filled droxidopa 100 MG Oral Capsule [Northera] in 2023, with total plan-and-beneficiary spending of $66,082,183 and an average per-beneficiary annual cost of $12,074.22. The plan-by-plan detail below lists exactly which PDP and MA-PD contracts carry droxidopa 100 MG Oral Capsule [Northera] today.
Coverage Details
- Formularies covering
- 1
- Plans covering
- 2
- Coverage rate
- 0%
- Tier range
- Tier 1, Preferred Generic
- Average tier
- Tier 1, Preferred Generic
Restrictions
- Prior authorization required
- 100% of formularies
- Step therapy required
- 0% of formularies
- Quantity limits
- 0% of formularies
2023 Medicare Spending
- Beneficiaries
- 5,473
- Total spending
- $66,082,183
- Avg per beneficiary
- $12,074.22
Tier Distribution Across Plans
Medicare Advantage Plans (MA-PD) Covering droxidopa 100 MG Oral Capsule [Northera]
2 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 |
Frequently Asked Questions
Is droxidopa 100 MG Oral Capsule [Northera] covered by Medicare Part D?
Yes, droxidopa 100 MG Oral Capsule [Northera] is covered by 2 Medicare Part D plans (0% of all Part D formularies).
What tier is droxidopa 100 MG Oral Capsule [Northera] on Medicare Part D plans?
droxidopa 100 MG Oral Capsule [Northera] averages Tier 1 across Part D plans, ranging from Tier 1 to Tier 1.
Does droxidopa 100 MG Oral Capsule [Northera] require prior authorization?
100% of Part D formularies require prior authorization for droxidopa 100 MG Oral Capsule [Northera]. Step therapy: 0%. Quantity limits: 0%.
How much does Medicare spend on droxidopa 100 MG Oral Capsule [Northera]?
In 2023, total Medicare Part D spending on droxidopa 100 MG Oral Capsule [Northera] was $66,082,183, covering 5,473 beneficiaries. The average spend per beneficiary was $12,074.22.
Read our methodology - how this data is sourced, computed, and verified.