duloxetine 60 MG Delayed Release Oral Capsule
duloxetine
RxCUI: 596934
What the CMS Formulary Data Shows for duloxetine 60 MG Delayed Release Oral Capsule
Per the CMS 2026 Part D formulary file, duloxetine 60 MG Delayed Release Oral Capsule (RxNorm concept RXCUI 596934, generic name duloxetine) appears on 330 distinct formulary files spanning 5,067 Medicare Part D plan offerings - 100% of enrollable Part D products, near-universal placement. Tier placement ranges from Tier 1 to Tier 4, with a cross-plan average of Tier 1.9.
Real-world access to duloxetine 60 MG Delayed Release Oral Capsule depends on utilization management as much as tier placement: 0% of covering formularies require prior authorization. 0% require step therapy. 93.9% apply quantity limits.
Historical spending context from the CMS Medicare Part D Drug Spending Dashboard shows 2,465,211 Part D beneficiaries filled duloxetine 60 MG Delayed Release Oral Capsule in 2023, with total plan-and-beneficiary spending of $398,813,266 and an average per-beneficiary annual cost of $161.78. The plan-by-plan detail below lists exactly which PDP and MA-PD contracts carry duloxetine 60 MG Delayed Release Oral Capsule today.
Coverage Details
- Formularies covering
- 330
- Plans covering
- 5,067
- Coverage rate
- 100%
- Tier range
- Tier 1 – Tier 4
- Average tier
- Tier 2, Generic
Restrictions
- Prior authorization required
- 0% of formularies
- Step therapy required
- 0% of formularies
- Quantity limits
- 93.9% of formularies
2023 Medicare Spending
- Beneficiaries
- 2,465,211
- Total spending
- $398,813,266
- Avg per beneficiary
- $161.78
Tier Distribution Across Plans
Medicare Advantage Plans (MA-PD) Covering duloxetine 60 MG Delayed Release Oral Capsule
100 Medicare Advantage plans with Part D drug coverage include this drug.
| Plan | Insurer | Tier | PA | Premium | States |
|---|---|---|---|---|---|
| Sentara Community Complete Select (HMO D-SNP) | SENTARA HEALTH PLANS | T1 | No | $0 | VA |
| Sentara Community Complete (HMO D-SNP) | SENTARA HEALTH PLANS | T1 | No | $0 | VA |
| Freedom VIP Care (HMO C-SNP) | FREEDOM HEALTH, INC. | T1 | No | $0 | FL |
| Freedom VIP Savings (HMO C-SNP) | FREEDOM HEALTH, INC. | T1 | No | $0 | FL |
| Freedom VIP Savings (HMO C-SNP) | FREEDOM HEALTH, INC. | T1 | No | $0 | FL |
| Freedom VIP Rewards (HMO C-SNP) | FREEDOM HEALTH, INC. | T1 | No | $0 | FL |
| Freedom VIP Rewards (HMO C-SNP) | FREEDOM HEALTH, INC. | T1 | No | $0 | FL |
| Optimum Diamond Rewards (HMO C-SNP) | OPTIMUM HEALTHCARE, INC. | T1 | No | $0 | FL |
| Optimum Diamond Savings (HMO C-SNP) | OPTIMUM HEALTHCARE, INC. | T1 | No | $0 | FL |
| Optimum Diamond Rewards (HMO C-SNP) | OPTIMUM HEALTHCARE, INC. | T1 | No | $0 | FL |
| Optimum Diamond (HMO C-SNP) | OPTIMUM HEALTHCARE, INC. | T1 | No | $0 | FL |
| Freedom Medi-Medi Partial (HMO D-SNP) | FREEDOM HEALTH, INC. | T1 | No | $0 | FL |
| Freedom Medi-Medi Full (HMO D-SNP) | FREEDOM HEALTH, INC. | T1 | No | $0 | FL |
| Optimum Emerald Partial (HMO D-SNP) | OPTIMUM HEALTHCARE, INC. | T1 | No | $0 | FL |
| Optimum Emerald Full (HMO D-SNP) | OPTIMUM HEALTHCARE, INC. | T1 | No | $0 | FL |
| Freedom Medicare Plan Rx (HMO) | FREEDOM HEALTH, INC. | T1 | No | $0 | FL |
| Freedom Medicare Plan Rx (HMO) | FREEDOM HEALTH, INC. | T1 | No | $0 | FL |
| Freedom VIP Savings COPD (HMO C-SNP) | FREEDOM HEALTH, INC. | T1 | No | $0 | FL |
| Freedom VIP Savings COPD (HMO C-SNP) | FREEDOM HEALTH, INC. | T1 | No | $0 | FL |
| Freedom Platinum Plan Rx (HMO) | FREEDOM HEALTH, INC. | T1 | No | $0 | FL |
| Freedom Platinum Plan Rx (HMO) | FREEDOM HEALTH, INC. | T1 | No | $0 | FL |
| Freedom Platinum Plan Rx (HMO) | FREEDOM HEALTH, INC. | T1 | No | $0 | FL |
| Freedom Platinum Plan Rx (HMO) | FREEDOM HEALTH, INC. | T1 | No | $0 | FL |
| Freedom Platinum Plan Rx (HMO) | FREEDOM HEALTH, INC. | T1 | No | $0 | FL |
| Freedom Platinum Rewards Plan Rx (HMO) | FREEDOM HEALTH, INC. | T1 | No | $0 | FL |
| Freedom Platinum Rewards Plan Rx (HMO) | FREEDOM HEALTH, INC. | T1 | No | $0 | FL |
| Freedom Platinum Rewards Plan Rx (HMO) | FREEDOM HEALTH, INC. | T1 | No | $0 | FL |
| Freedom Platinum Rewards Plan Rx (HMO) | FREEDOM HEALTH, INC. | T1 | No | $0 | FL |
| Freedom Platinum Rewards Plan Rx (HMO) | FREEDOM HEALTH, INC. | T1 | No | $0 | FL |
| Freedom Platinum Rewards Plan Rx (HMO) | FREEDOM HEALTH, INC. | T1 | No | $0 | FL |
| Freedom Máximo (HMO-POS) | FREEDOM HEALTH, INC. | T1 | No | $0 | FL |
| Freedom Máximo (HMO-POS) | FREEDOM HEALTH, INC. | T1 | No | $0 | FL |
| Optimum Gold Rewards Plan (HMO) | OPTIMUM HEALTHCARE, INC. | T1 | No | $0 | FL |
| Optimum Platinum Plan (HMO) | OPTIMUM HEALTHCARE, INC. | T1 | No | $0 | FL |
| Optimum Gold Plan (HMO) | OPTIMUM HEALTHCARE, INC. | T1 | No | $0 | FL |
| Optimum Gold Rewards Plan (HMO) | OPTIMUM HEALTHCARE, INC. | T1 | No | $0 | FL |
| Optimum Gold Rewards Plan (HMO) | OPTIMUM HEALTHCARE, INC. | T1 | No | $0 | FL |
| Optimum Diamond Rewards COPD (HMO C-SNP) | OPTIMUM HEALTHCARE, INC. | T1 | No | $0 | FL |
| Optimum Diamond Savings COPD (HMO C-SNP) | OPTIMUM HEALTHCARE, INC. | T1 | No | $0 | FL |
| Optimum Gold Plus Plan (HMO) | OPTIMUM HEALTHCARE, INC. | T1 | No | $0 | FL |
| Optimum Diamond Rewards COPD (HMO C-SNP) | OPTIMUM HEALTHCARE, INC. | T1 | No | $0 | FL |
| Florida Complete Care-Duals VIP (HMO-POS D-SNP) | HPMP OF FLORIDA, INC. | T1 | No | $0 | FL |
| 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 |
| Providence Medicare Extra Part B Only + Rx (HMO) | PROVIDENCE HEALTH ASSURANCE | T1 | No | $0 | OR |
| Providence Medicare Prime + Rx (HMO) | PROVIDENCE HEALTH ASSURANCE | T1 | No | $0 | OR |
| Providence Medicare Dual Plus (HMO D-SNP) | PROVIDENCE HEALTH ASSURANCE | T1 | No | $0 | OR |
| Providence Medicare Timber + Rx (HMO) | PROVIDENCE HEALTH ASSURANCE | T1 | No | $0 | OR, WA |
| Providence Medicare Pine + Rx (HMO) | PROVIDENCE HEALTH ASSURANCE | T1 | No | $0 | WA |
Frequently Asked Questions
Is duloxetine 60 MG Delayed Release Oral Capsule covered by Medicare Part D?
Yes, duloxetine 60 MG Delayed Release Oral Capsule is covered by 5,067 Medicare Part D plans (100% of all Part D formularies).
What tier is duloxetine 60 MG Delayed Release Oral Capsule on Medicare Part D plans?
duloxetine 60 MG Delayed Release Oral Capsule averages Tier 1.9 across Part D plans, ranging from Tier 1 to Tier 4.
Does duloxetine 60 MG Delayed Release Oral Capsule require prior authorization?
0% of Part D formularies require prior authorization for duloxetine 60 MG Delayed Release Oral Capsule. Step therapy: 0%. Quantity limits: 93.9%.
How much does Medicare spend on duloxetine 60 MG Delayed Release Oral Capsule?
In 2023, total Medicare Part D spending on duloxetine 60 MG Delayed Release Oral Capsule was $398,813,266, covering 2,465,211 beneficiaries. The average spend per beneficiary was $161.78.
Read our methodology - how this data is sourced, computed, and verified.