Medicare Part D coverage · dutasteride · RxCUI 351172
dutasteride 0.5 MG Oral Capsule
Per the CMS 2026 Part D formulary file, dutasteride 0.5 MG Oral Capsule is covered by 5,014 Medicare Part D plans (99.2% of enrollable products), averaging Tier 2, with prior authorization required on 0% of covering formularies.
- 99.2%
- Plan coverage
- 5,014
- Plans covering
- T2
- Avg tier
- 0%
- Prior auth required
What the CMS Formulary Data Shows for dutasteride 0.5 MG Oral Capsule
Per the CMS 2026 Part D formulary file, dutasteride 0.5 MG Oral Capsule (RxNorm concept RXCUI 351172, generic name dutasteride) appears on 326 distinct formulary files spanning 5,014 Medicare Part D plan offerings - 99.2% of enrollable Part D products, near-universal placement. Tier placement ranges from Tier 1 to Tier 4, with a cross-plan average of Tier 2.
Real-world access to dutasteride 0.5 MG Oral Capsule depends on utilization management as much as tier placement: 0% of covering formularies require prior authorization. 0.3% require step therapy. 56.4% apply quantity limits.
Historical spending context from the CMS Medicare Part D Drug Spending Dashboard shows 224,682 Part D beneficiaries filled dutasteride 0.5 MG Oral Capsule in 2023, with total plan-and-beneficiary spending of $40,753,169 and an average per-beneficiary annual cost of $181.38. The plan-by-plan detail below lists exactly which PDP and MA-PD contracts carry dutasteride 0.5 MG Oral Capsule today.
Coverage Details
- Formularies covering
- 326
- Plans covering
- 5,014
- Coverage rate
- 99.2%
- Tier range
- Tier 1 – Tier 4
- Average tier
- Tier 2, Generic
Restrictions
- Prior authorization required
- 0% of formularies
- Step therapy required
- 0.3% of formularies
- Quantity limits
- 56.4% of formularies
2023 Medicare Spending
- Beneficiaries
- 224,682
- Total spending
- $40,753,169
- Avg per beneficiary
- $181.38
Tier Distribution Across Plans
Medicare Advantage Plans (MA-PD) Covering dutasteride 0.5 MG 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 |
| 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 |
| Providence Medicare Extra + Rx (HMO) | Providence Health Assurance | T1 | No | $0 | OR, WA |
| Providence Medicare Sycamore + Rx (HMO) | Providence Health Assurance | T1 | No | $0 | CA |
| Mercy Care Advantage (HMO D-SNP) | Mercy Care | T1 | No | $0 | AZ |
| Mercy Care Advantage (HMO D-SNP) | Mercy Care | T1 | No | $0 | AZ |
| Mercy Care Advantage (HMO D-SNP) | Mercy Care | T1 | No | $0 | AZ |
| Elderplan Plus Long-Term Care (HMO-POS D-SNP) | Elderplan, Inc. | T1 | No | $0 | NY |
| Health Choice Pathway (HMO D-SNP) | Health Choice Arizona, Inc. | T1 | No | $0 | AZ |
| Healthfirst CompleteCare (HMO D-SNP) | Healthfirst Health Plan, Inc. | T1 | No | $0 | NY |
| IMCare Classic (HMO D-SNP) | Itasca Medical Care | T1 | No | $0 | MN |
Show the next 30 plans
| Johns Hopkins Advantage MD D-SNP (HMO D-SNP) | Hopkins Health Advantage, Inc. | T1 | No | $0 | MD |
| MetroPlus UltraCare (HMO D-SNP) | Metroplus Health Plan, Inc. | T1 | No | $0 | NY |
| Upper Peninsula Health Plan MI Coordinated Health (HMO D-SNP) | Upper Peninsula Health Plan, LLC | T1 | No | $0 | MI |
| CareSource Dual Advantage (HMO D-SNP) | Caresource Georgia Co. | T1 | No | $0 | GA |
| Senior Whole Health SCO (HMO D-SNP) | Senior Whole Health, LLC | T1 | No | $0 | MA |
| Senior Whole Health SCO NHC (HMO D-SNP) | Senior Whole Health, LLC | T1 | No | $0 | MA |
| Molina One Care (HMO D-SNP) | Senior Whole Health, LLC | T1 | No | $0 | MA |
| HAP CareSource MI Coordinated Health (HMO D-SNP) | HAP Caresource | T1 | No | $0 | MI |
| PruittHealth Premier D-SNP (HMO D-SNP) | Pruitthealth Premier, Inc. | T1 | No | $0 | GA |
| KeyCare Advantage Plus (HMO C-SNP) | Isnp Ventures, LLC | T1 | No | $0 | MD |
| Premier Care (HMO-POS I-SNP) | Lifeworks Advantage, LLC | T1 | No | $0 | VA |
| Premier Care (HMO I-SNP) | Align Senior Care California Inc. | T1 | No | $0 | CA |
| Advantage Care (HMO) | Align Senior Care California Inc. | T1 | No | $0 | CA |
| Premier Care (HMO-POS I-SNP) | Align Senior Care MI, LLC | T1 | No | $0 | MI |
| Premier Care (HMO I-SNP) | Align Senior Care Florida, Inc. | T1 | No | $0 | FL |
| Perennial Advantage Freedom (HMO-POS) | Perennial Advantage OF Colorado, Inc. | T1 | No | $0 | CO |
| Perennial Advantage Premier (HMO-POS I-SNP) | Perennial Advantage OF Colorado, Inc. | T1 | No | $0 | CO |
| Perennial Advantage Freedom (HMO) | Perennial Advantage OF Colorado, Inc. | T1 | No | $0 | PA |
| Perennial Advantage Premier (HMO I-SNP) | Perennial Advantage OF Colorado, Inc. | T1 | No | $0 | PA |
| Perennial Advantage Freedom (HMO-POS) | Perennial Advantage OF Ohio, Inc. | T1 | No | $0 | OH |
| Perennial Advantage Premier (HMO-POS I-SNP) | Perennial Advantage OF Ohio, Inc. | T1 | No | $0 | OH |
| ProCare Advantage - Diabetes Care Management (HMO-POS C-SNP) | Procare Advantage, LLC | T1 | No | $0 | TX |
| PruittHealth Premier Advantage (HMO I-SNP) | Pruitthealth Premier, Inc. | T1 | No | $0 | GA |
| Senior Health Plan Silver Plus (HMO) | Communitycare Government Programs, Inc. | T1 | No | $0 | OK |
| Senior Health Plan Oklahoma Dual Complete (HMO D-SNP) | Communitycare Government Programs, Inc. | T1 | No | $0 | OK |
| Community First Medicare Advantage Alamo Plan (HMO) | Community First Health Plans, Inc. | T1 | No | $0 | TX |
| Community First Medicare Advantage D-SNP (HMO D-SNP) | Community First Health Plans, Inc. | T1 | No | $0 | TX |
| Community DualCare Aligned (HMO D-SNP) | Community Health Choice Texas, Inc. | T1 | No | $0 | TX |
| Community DualCare Access (HMO D-SNP) | Community Health Choice Texas, Inc. | T1 | No | $0 | TX |
| El Paso Health Medicare Advantage Dual (HMO D-SNP) | EL Paso First Health Plans, Inc. | T1 | No | $0 | TX |
Showing top 50 of 100 plans.
Frequently Asked Questions
Is dutasteride 0.5 MG Oral Capsule covered by Medicare Part D?
Yes, dutasteride 0.5 MG Oral Capsule is covered by 5,014 Medicare Part D plans (99.2% of all Part D formularies).
What tier is dutasteride 0.5 MG Oral Capsule on Medicare Part D plans?
dutasteride 0.5 MG Oral Capsule averages Tier 2 across Part D plans, ranging from Tier 1 to Tier 4.
Does dutasteride 0.5 MG Oral Capsule require prior authorization?
0% of Part D formularies require prior authorization for dutasteride 0.5 MG Oral Capsule. Step therapy: 0.3%. Quantity limits: 56.4%.
How much does Medicare spend on dutasteride 0.5 MG Oral Capsule?
In 2023, total Medicare Part D spending on dutasteride 0.5 MG Oral Capsule was $40,753,169, covering 224,682 beneficiaries. The average spend per beneficiary was $181.38.
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
- metronidazole 10 MG/ML Topical Cream [Noritate] 0% PA
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- buspirone hydrochloride 10 MG Oral Capsule [Bucapsol] 0% PA
- diflunisal 375 MG Oral Tablet [Dolobid] 0% PA
- hydrocortisone 1 MG/ML Oral Solution [Khindivi] 0% PA
- indomethacin 50 MG Rectal Suppository [Indocin] 0% PA