esomeprazole 20 MG Granules for Oral Suspension [Nexium]
esomeprazole
RxCUI: 861576
What the CMS Formulary Data Shows for esomeprazole 20 MG Granules for Oral Suspension [Nexium]
Per the CMS 2026 Part D formulary file, esomeprazole 20 MG Granules for Oral Suspension [Nexium] (RxNorm concept RXCUI 861576, generic name esomeprazole) 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 esomeprazole 20 MG Granules for Oral Suspension [Nexium] depends on utilization management as much as tier placement: 0% of covering formularies require prior authorization. 100% require step therapy. 100% apply quantity limits.
Historical spending context from the CMS Medicare Part D Drug Spending Dashboard shows 685,529 Part D beneficiaries filled esomeprazole 20 MG Granules for Oral Suspension [Nexium] in 2023, with total plan-and-beneficiary spending of $172,016,821 and an average per-beneficiary annual cost of $250.93. The plan-by-plan detail below lists exactly which PDP and MA-PD contracts carry esomeprazole 20 MG Granules for Oral Suspension [Nexium] 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
- 0% of formularies
- Step therapy required
- 100% of formularies
- Quantity limits
- 100% of formularies
2023 Medicare Spending
- Beneficiaries
- 685,529
- Total spending
- $172,016,821
- Avg per beneficiary
- $250.93
Tier Distribution Across Plans
Medicare Advantage Plans (MA-PD) Covering esomeprazole 20 MG Granules for Oral Suspension [Nexium]
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 | No | $0 | NY |
| Hamaspik Medicare Select (HMO D-SNP) | HAMASPIK, INC. | T1 | No | $34.50 | NY |
Frequently Asked Questions
Is esomeprazole 20 MG Granules for Oral Suspension [Nexium] covered by Medicare Part D?
Yes, esomeprazole 20 MG Granules for Oral Suspension [Nexium] is covered by 2 Medicare Part D plans (0% of all Part D formularies).
What tier is esomeprazole 20 MG Granules for Oral Suspension [Nexium] on Medicare Part D plans?
esomeprazole 20 MG Granules for Oral Suspension [Nexium] averages Tier 1 across Part D plans, ranging from Tier 1 to Tier 1.
Does esomeprazole 20 MG Granules for Oral Suspension [Nexium] require prior authorization?
0% of Part D formularies require prior authorization for esomeprazole 20 MG Granules for Oral Suspension [Nexium]. Step therapy: 100%. Quantity limits: 100%.
How much does Medicare spend on esomeprazole 20 MG Granules for Oral Suspension [Nexium]?
In 2023, total Medicare Part D spending on esomeprazole 20 MG Granules for Oral Suspension [Nexium] was $172,016,821, covering 685,529 beneficiaries. The average spend per beneficiary was $250.93.
Read our methodology - how this data is sourced, computed, and verified.