epinephrine 20 MG/ML Nasal Spray [Neffy]
epinephrine
RxCUI: 2693448
What the CMS Formulary Data Shows for epinephrine 20 MG/ML Nasal Spray [Neffy]
Per the CMS 2026 Part D formulary file, epinephrine 20 MG/ML Nasal Spray [Neffy] (RxNorm concept RXCUI 2693448, generic name epinephrine) appears on 9 distinct formulary files spanning 49 Medicare Part D plan offerings - 1% of enrollable Part D products, selective placement; verify formulary inclusion before enrolling. Tier placement ranges from Tier 2 to Tier 4, with a cross-plan average of Tier 3.4.
Real-world access to epinephrine 20 MG/ML Nasal Spray [Neffy] depends on utilization management as much as tier placement: 0% of covering formularies require prior authorization. 0% require step therapy. 44.4% apply quantity limits.
Historical spending context from the CMS Medicare Part D Drug Spending Dashboard shows 413,026 Part D beneficiaries filled epinephrine 20 MG/ML Nasal Spray [Neffy] in 2023, with total plan-and-beneficiary spending of $133,365,359 and an average per-beneficiary annual cost of $322.90. The plan-by-plan detail below lists exactly which PDP and MA-PD contracts carry epinephrine 20 MG/ML Nasal Spray [Neffy] today.
Coverage Details
- Formularies covering
- 9
- Plans covering
- 49
- Coverage rate
- 1%
- Tier range
- Tier 2 – Tier 4
- Average tier
- Tier 3, Preferred Brand
Restrictions
- Prior authorization required
- 0% of formularies
- Step therapy required
- 0% of formularies
- Quantity limits
- 44.4% of formularies
2023 Medicare Spending
- Beneficiaries
- 413,026
- Total spending
- $133,365,359
- Avg per beneficiary
- $322.90
Tier Distribution Across Plans
Medicare Advantage Plans (MA-PD) Covering epinephrine 20 MG/ML Nasal Spray [Neffy]
49 Medicare Advantage plans with Part D drug coverage include this drug.
| Plan | Insurer | Tier | PA | Premium | States |
|---|---|---|---|---|---|
| CareAdvantage (HMO D-SNP) | SAN MATEO HEALTH COMMISSION | T2 | No | $0 | CA |
| CalOptima Health OneCare Complete (HMO D-SNP) | ORANGE COUNTY HEALTH AUTHORITY | T2 | No | $0 | CA |
| BlueCare Plus (HMO D-SNP) | VOLUNTEER STATE HEALTH PLAN | T3 | No | $0 | TN |
| BlueCare Plus Choice (HMO D-SNP) | VOLUNTEER STATE HEALTH PLAN | T3 | No | $0 | TN |
| BlueCare Plus Select (HMO D-SNP) | VOLUNTEER STATE HEALTH PLAN | T3 | No | $0 | TN |
| BlueAdvantage Sapphire (PPO) | BLUECROSS BLUESHIELD OF TENNESSEE, INC. | T4 | No | $0 | TN |
| BlueAdvantage Sapphire (PPO) | BLUECROSS BLUESHIELD OF TENNESSEE, INC. | T4 | No | $0 | TN |
| BlueAdvantage Garnet (PPO) | BLUECROSS BLUESHIELD OF TENNESSEE, INC. | T4 | No | $0 | TN |
| BlueAdvantage Garnet (PPO) | BLUECROSS BLUESHIELD OF TENNESSEE, INC. | T4 | No | $0 | TN |
| BlueAdvantage Sapphire (PPO) | BLUECROSS BLUESHIELD OF TENNESSEE, INC. | T4 | No | $0 | TN |
| BlueAdvantage Sapphire (PPO) | BLUECROSS BLUESHIELD OF TENNESSEE, INC. | T4 | No | $0 | GA |
| BlueAdvantage Total Heart and Diabetes (PPO C-SNP) | BLUECROSS BLUESHIELD OF TENNESSEE, INC. | T4 | No | $0 | GA, TN |
| BlueAdvantage Total Heart and Diabetes (PPO C-SNP) | BLUECROSS BLUESHIELD OF TENNESSEE, INC. | T4 | No | $0 | TN |
| Aspirus Health Plan Essential Rx (PPO) | ASPIRUS HEALTH PLAN, INC. | T4 | No | $0 | WI |
| Prominence Plus (HMO) | PROMINENCE HEALTHFIRST | T4 | No | $0 | NV |
| Prominence Plus (HMO) | PROMINENCE HEALTHFIRST | T4 | No | $0 | NV |
| Prominence Dual (HMO D-SNP) | PROMINENCE HEALTHFIRST | T4 | No | $0 | NV |
| Prominence Dual (HMO D-SNP) | PROMINENCE HEALTHFIRST | T4 | No | $0 | NV |
| Prominence Giveback (HMO) | PROMINENCE HEALTHFIRST | T4 | No | $0 | NV |
| Prominence Plus (HMO) | PROMINENCE HEALTHFIRST OF FLORIDA INC | T4 | No | $0 | FL |
| Prominence Giveback (HMO) | PROMINENCE HEALTHFIRST OF FLORIDA INC | T4 | No | $0 | FL |
| Prominence Plus (HMO) | PROMINENCE HEALTHFIRST OF TEXAS | T4 | No | $0 | TX |
| Prominence Plus (HMO) | PROMINENCE HEALTHFIRST OF TEXAS | T4 | No | $0 | TX |
| Prominence Dual (HMO D-SNP) | PROMINENCE HEALTHFIRST OF TEXAS | T4 | No | $0 | TX |
| Prominence Extra Help (HMO) | PROMINENCE HEALTHFIRST OF TEXAS | T4 | No | $0 | TX |
| Prominence Beyond (HMO) | PROMINENCE HEALTHFIRST OF TEXAS | T4 | No | $0 | TX |
| Prominence Giveback (HMO) | PROMINENCE HEALTHFIRST OF TEXAS | T4 | No | $0 | TX |
| Prominence Giveback (HMO) | PROMINENCE HEALTHFIRST OF TEXAS | T4 | No | $0 | TX |
| Prominence Dual (HMO D-SNP) | PROMINENCE HEALTHFIRST OF TEXAS | T4 | No | $0 | TX |
| Prominence Beyond (HMO-POS) | PROMINENCE HEALTHFIRST OF TEXAS | T4 | No | $0 | TX |
| Prominence Dual (HMO D-SNP) | PROMINENCE HEALTHFIRST OF FLORIDA INC | T4 | No | $0 | FL |
| Prominence Diabetes and Heart Giveback (HMO C-SNP) | PROMINENCE HEALTHFIRST | T4 | No | $0 | NV |
| Prominence Diabetes and Heart Giveback (HMO C-SNP) | PROMINENCE HEALTHFIRST OF FLORIDA INC | T4 | No | $0 | FL |
| Prominence Diabetes and Heart Giveback (HMO C-SNP) | PROMINENCE HEALTHFIRST OF TEXAS | T4 | No | $0 | TX |
| Prominence Diabetes and Heart Care Plus (HMO C-SNP) | PROMINENCE HEALTHFIRST OF TEXAS | T4 | No | $0 | TX |
| Prominence Diabetes and Heart Giveback (HMO C-SNP) | PROMINENCE HEALTHFIRST OF TEXAS | T4 | No | $0 | TX |
| Prominence Extra Help (HMO) | PROMINENCE HEALTHFIRST | T4 | No | $4.20 | NV |
| Prominence Extra Help (HMO) | PROMINENCE HEALTHFIRST OF FLORIDA INC | T4 | No | $4.80 | FL |
| Prominence Extra Help (HMO) | PROMINENCE HEALTHFIRST OF TEXAS | T4 | No | $4.80 | TX |
| Prominence Extra Help (HMO) | PROMINENCE HEALTHFIRST | T4 | No | $9.50 | NV |
| BlueAdvantage Extra (PPO) | BLUECROSS BLUESHIELD OF TENNESSEE, INC. | T4 | No | $27.60 | GA, TN |
| BlueAdvantage Total Heart and Diabetes Plus (PPO C-SNP) | BLUECROSS BLUESHIELD OF TENNESSEE, INC. | T4 | No | $27.70 | TN |
| BlueAdvantage Ruby (PPO) | BLUECROSS BLUESHIELD OF TENNESSEE, INC. | T4 | No | $46.00 | TN |
| BlueAdvantage Diamond (PPO) | BLUECROSS BLUESHIELD OF TENNESSEE, INC. | T4 | No | $88.50 | TN |
| BlueAdvantage Ruby (PPO) | BLUECROSS BLUESHIELD OF TENNESSEE, INC. | T4 | No | $89.00 | TN |
| BlueAdvantage Diamond (PPO) | BLUECROSS BLUESHIELD OF TENNESSEE, INC. | T4 | No | $89.40 | TN |
| BlueAdvantage Ruby (PPO) | BLUECROSS BLUESHIELD OF TENNESSEE, INC. | T4 | No | $92.00 | TN |
| BlueAdvantage Diamond (PPO) | BLUECROSS BLUESHIELD OF TENNESSEE, INC. | T4 | No | $102.80 | TN |
| BlueAdvantage Ruby (PPO) | BLUECROSS BLUESHIELD OF TENNESSEE, INC. | T4 | No | $107.00 | TN |
Frequently Asked Questions
Is epinephrine 20 MG/ML Nasal Spray [Neffy] covered by Medicare Part D?
Yes, epinephrine 20 MG/ML Nasal Spray [Neffy] is covered by 49 Medicare Part D plans (1% of all Part D formularies).
What tier is epinephrine 20 MG/ML Nasal Spray [Neffy] on Medicare Part D plans?
epinephrine 20 MG/ML Nasal Spray [Neffy] averages Tier 3.4 across Part D plans, ranging from Tier 2 to Tier 4.
Does epinephrine 20 MG/ML Nasal Spray [Neffy] require prior authorization?
0% of Part D formularies require prior authorization for epinephrine 20 MG/ML Nasal Spray [Neffy]. Step therapy: 0%. Quantity limits: 44.4%.
How much does Medicare spend on epinephrine 20 MG/ML Nasal Spray [Neffy]?
In 2023, total Medicare Part D spending on epinephrine 20 MG/ML Nasal Spray [Neffy] was $133,365,359, covering 413,026 beneficiaries. The average spend per beneficiary was $322.90.
Read our methodology - how this data is sourced, computed, and verified.