febuxostat 40 MG Oral Tablet

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febuxostat

RxCUI: 834235

Important: Drug coverage and costs vary by plan and location. Verify coverage directly with your Medicare plan before filling a prescription. This is informational data only and should not replace advice from your healthcare provider or pharmacist.
81.4%
Plan Coverage
4,123
Plans Covering
T2.6
Avg Tier
7.2%
Prior Auth Required

What the CMS Formulary Data Shows for febuxostat 40 MG Oral Tablet

Per the CMS 2026 Part D formulary file, febuxostat 40 MG Oral Tablet (RxNorm concept RXCUI 834235, generic name febuxostat) appears on 223 distinct formulary files spanning 4,123 Medicare Part D plan offerings - 81.4% of enrollable Part D products, near-universal placement. Tier placement ranges from Tier 1 to Tier 4, with a cross-plan average of Tier 2.6.

Real-world access to febuxostat 40 MG Oral Tablet depends on utilization management as much as tier placement: 7.2% of covering formularies require prior authorization. 59.2% require step therapy. 47.5% apply quantity limits.

Historical spending context from the CMS Medicare Part D Drug Spending Dashboard shows 74,956 Part D beneficiaries filled febuxostat 40 MG Oral Tablet in 2023, with total plan-and-beneficiary spending of $56,543,659 and an average per-beneficiary annual cost of $754.36. The plan-by-plan detail below lists exactly which PDP and MA-PD contracts carry febuxostat 40 MG Oral Tablet today.

Coverage Details

Formularies covering
223
Plans covering
4,123
Coverage rate
81.4%
Tier range
Tier 1 – Tier 4
Average tier
Tier 3, Preferred Brand

Restrictions

Prior authorization required
7.2% of formularies
Step therapy required
59.2% of formularies
Quantity limits
47.5% of formularies

2023 Medicare Spending

Beneficiaries
74,956
Total spending
$56,543,659
Avg per beneficiary
$754.36

Tier Distribution Across Plans

100 plans
Tier 1, Preferred Generic

Medicare Advantage Plans (MA-PD) Covering febuxostat 40 MG Oral Tablet

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
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
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
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
Simpra Advantage Dual Care (PPO D-SNP) SIMPRA ADVANTAGE, INC. T1 No $0 AL
CareAdvantage (HMO D-SNP) SAN MATEO HEALTH COMMISSION T1 No $0 CA
NaviCare (HMO D-SNP) FALLON COMMUNITY HEALTH PLAN T1 No $0 MA
Hamaspik Medicare Choice (HMO D-SNP) HAMASPIK, INC. T1 No $0 NY
SeniorCare Complete (HMO D-SNP) SOUTH COUNTRY HEALTH ALLIANCE T1 No $0 MN
AbilityCare (HMO D-SNP) SOUTH COUNTRY HEALTH ALLIANCE T1 No $0 MN
Alameda Alliance Wellness (HMO D-SNP) ALAMEDA ALLIANCE FOR HEALTH T1 No $0 CA
PHP (HMO C-SNP) AIDS HEALTHCARE FOUNDATION T1 No $0 CA
Elevate Medicare Choice (HMO D-SNP) DENVER HEALTH MEDICAL PLAN, INC. T1 No $0 CO
AllCare Advantage Redwood Rx (HMO D-SNP) ALLCARE HEALTH PLAN, INC. T1 No $0 OR
PrimeWest Senior Health Complete (HMO D-SNP) PRIMEWEST RURAL MN HEALTH CARE ACCESS INITIATIVE T1 No $0 MN
Prime Health Complete (HMO D-SNP) PRIMEWEST RURAL MN HEALTH CARE ACCESS INITIATIVE T1 No $0 MN
DualConnect (HMO D-SNP) SANTA CLARA COUNTY HEALTH AUTHORITY T1 No $0 CA
VNS Health Total (HMO D-SNP) VNS CHOICE T1 No $0 NY
Alterwood Advantage Dual Secure (HMO D-SNP) ALTERWOOD ADVANTAGE, INC. T1 No $0 MD
Nascentia Dual Advantage (HMO D-SNP) VISITING NURSE ASSOCIATION OF CENTRAL NEW YORK T1 No $0 NY
Abilis Health Community (HMO I-SNP) SIGNATURE ADVANTAGE, LLC T1 No $0 KY, TN
Arkansas Integrated Providers (AIP) Dual Advantage (HMO D-SNP) ARKANSAS SUPERIOR SELECT, INC. T1 No $0 AR
Community Care's Partnership Program (HMO D-SNP) COMMUNITY CARE HEALTH PLAN, INC. T1 No $0 WI
Platino Blindao (HMO D-SNP) TRIPLE S ADVANTAGE, INC. T1 No $0 PR
Platino Enlace (HMO D-SNP) TRIPLE S ADVANTAGE, INC. T1 No $0 PR
PLATINO ADVANCE (HMO D-SNP) TRIPLE S ADVANTAGE, INC. T1 No $0 PR
PLATINO PLUS (HMO D-SNP) TRIPLE S ADVANTAGE, INC. T1 No $0 PR
Mass General Brigham SCO (HMO D-SNP) MASS GENERAL BRIGHAM HEALTH PLAN, INC T1 No $0 MA
Mass General Brigham One Care (HMO D-SNP) MASS GENERAL BRIGHAM HEALTH PLAN, INC T1 No $0 MA
Highmark Wholecare Medicare Assured Diamond (HMO D-SNP) GATEWAY HEALTH PLAN, INC. T1 No $0 PA
Highmark Wholecare Medicare Assured Diamond (HMO D-SNP) GATEWAY HEALTH PLAN, INC. T1 No $0 PA
Highmark Health Options Duals (HMO D-SNP) HIGHMARK HEALTH OPTIONS WEST VIRGINIA INC. T1 No $0 WV
Highmark Health Options Duals (HMO D-SNP) HIGHMARK BCBSD, INC. T1 No $0 DE
Leon MediExtra (HMO) LEON HEALTH, INC. T1 No $0 FL
Leon MediDual (HMO D-SNP) LEON HEALTH, INC. T1 No $0 FL
Leon MediMore (HMO) LEON HEALTH, INC. T1 No $0 FL
Leon MediMax (HMO D-SNP) LEON HEALTH, INC. T1 No $0 FL
Longevity Health Plan (HMO I-SNP) LONGEVITY HEALTH PLAN OF FLORIDA, INC. T1 No $4.80 FL
Senior Care (HMO I-SNP) ALIGN SENIOR CARE FLORIDA, INC. T1 No $4.80 FL
ProCare Advantage (HMO-POS I-SNP) PROCARE ADVANTAGE, LLC T1 No $4.80 TX
ProCare Advantage - Kidney Care (HMO-POS C-SNP) PROCARE ADVANTAGE, LLC T1 No $4.80 TX
American Health Advantage of Florida (HMO I-SNP) AMERICAN HEALTH PLAN OF FL, INC. T1 No $4.80 FL
SECUR Advantage (HMO I-SNP) SECUR INC T1 No $4.80 FL
SECUR Enhanced (HMO I-SNP) SECUR INC T1 No $4.80 FL
Gold Dialysis & Kidney Complete (HMO-POS C-SNP) GOLD KIDNEY OF FLORIDA INC T1 No $4.80 FL

Frequently Asked Questions

Is febuxostat 40 MG Oral Tablet covered by Medicare Part D?

Yes, febuxostat 40 MG Oral Tablet is covered by 4,123 Medicare Part D plans (81.4% of all Part D formularies).

What tier is febuxostat 40 MG Oral Tablet on Medicare Part D plans?

febuxostat 40 MG Oral Tablet averages Tier 2.6 across Part D plans, ranging from Tier 1 to Tier 4.

Does febuxostat 40 MG Oral Tablet require prior authorization?

7.2% of Part D formularies require prior authorization for febuxostat 40 MG Oral Tablet. Step therapy: 59.2%. Quantity limits: 47.5%.

How much does Medicare spend on febuxostat 40 MG Oral Tablet?

In 2023, total Medicare Part D spending on febuxostat 40 MG Oral Tablet was $56,543,659, covering 74,956 beneficiaries. The average spend per beneficiary was $754.36.

Data sourced from the Centers for Medicare & Medicaid Services (CMS). See our methodology for details. Retrieved and formatted by PlainMedicare Editorial