fenofibrate 150 MG Oral Capsule [Lipofen]
fenofibrate
RxCUI: 702055
What the CMS Formulary Data Shows for fenofibrate 150 MG Oral Capsule [Lipofen]
Per the CMS 2026 Part D formulary file, fenofibrate 150 MG Oral Capsule [Lipofen] (RxNorm concept RXCUI 702055, generic name fenofibrate) appears on 1 distinct formulary file spanning 10 Medicare Part D plan offerings - 0.2% of enrollable Part D products, selective placement; verify formulary inclusion before enrolling. Tier placement ranges from Tier 4 to Tier 4, with a cross-plan average of Tier 4.
Real-world access to fenofibrate 150 MG Oral Capsule [Lipofen] depends on utilization management as much as tier placement: 0% of covering formularies require prior authorization. 0% require step therapy. 0% apply quantity limits.
Historical spending context from the CMS Medicare Part D Drug Spending Dashboard shows 500,170 Part D beneficiaries filled fenofibrate 150 MG Oral Capsule [Lipofen] in 2023, with total plan-and-beneficiary spending of $74,983,711 and an average per-beneficiary annual cost of $149.92. The plan-by-plan detail below lists exactly which PDP and MA-PD contracts carry fenofibrate 150 MG Oral Capsule [Lipofen] today.
Coverage Details
- Formularies covering
- 1
- Plans covering
- 10
- Coverage rate
- 0.2%
- Tier range
- Tier 4, Non-Preferred
- Average tier
- Tier 4, Non-Preferred
Restrictions
- Prior authorization required
- 0% of formularies
- Step therapy required
- 0% of formularies
- Quantity limits
- 0% of formularies
2023 Medicare Spending
- Beneficiaries
- 500,170
- Total spending
- $74,983,711
- Avg per beneficiary
- $149.92
Tier Distribution Across Plans
Standalone Drug Plans (PDP) Covering fenofibrate 150 MG Oral Capsule [Lipofen]
2 standalone prescription drug plans include this drug.
| Plan | Insurer | Tier | PA | ST | Premium | States |
|---|---|---|---|---|---|---|
| Blue Rx PDP Complete (PDP) | HM HEALTH INSURANCE COMPANY | T4 | No | No | $164.80 | - |
| Blue Rx PDP Plus (PDP) | HM HEALTH INSURANCE COMPANY | T4 | No | No | $193.20 | - |
Medicare Advantage Plans (MA-PD) Covering fenofibrate 150 MG Oral Capsule [Lipofen]
8 Medicare Advantage plans with Part D drug coverage include this drug.
| Plan | Insurer | Tier | PA | Premium | States |
|---|---|---|---|---|---|
| Security Blue HMO-POS Standard (HMO-POS) | HIGHMARK CHOICE COMPANY | T4 | No | $51.80 | PA |
| Freedom Blue PPO Select (PPO) | HIGHMARK SENIOR HEALTH COMPANY | T4 | No | $95.70 | PA |
| Security Blue HMO-POS Deluxe (HMO-POS) | HIGHMARK CHOICE COMPANY | T4 | No | $95.90 | PA |
| Freedom Blue PPO Standard (PPO) | HIGHMARK SENIOR HEALTH COMPANY | T4 | No | $98.20 | PA |
| Freedom Blue PPO Select (PPO) | HIGHMARK SENIOR HEALTH COMPANY | T4 | No | $115.70 | PA |
| Freedom Blue PPO Deluxe (PPO) | HIGHMARK SENIOR HEALTH COMPANY | T4 | No | $122.40 | PA |
| Freedom Blue PPO Classic (PPO) | HIGHMARK SENIOR HEALTH COMPANY | T4 | No | $140.90 | PA |
| Freedom Blue PPO Classic (PPO) | HIGHMARK SENIOR HEALTH COMPANY | T4 | No | $145.40 | PA |
Frequently Asked Questions
Is fenofibrate 150 MG Oral Capsule [Lipofen] covered by Medicare Part D?
Yes, fenofibrate 150 MG Oral Capsule [Lipofen] is covered by 10 Medicare Part D plans (0.2% of all Part D formularies).
What tier is fenofibrate 150 MG Oral Capsule [Lipofen] on Medicare Part D plans?
fenofibrate 150 MG Oral Capsule [Lipofen] averages Tier 4 across Part D plans, ranging from Tier 4 to Tier 4.
Does fenofibrate 150 MG Oral Capsule [Lipofen] require prior authorization?
0% of Part D formularies require prior authorization for fenofibrate 150 MG Oral Capsule [Lipofen]. Step therapy: 0%. Quantity limits: 0%.
How much does Medicare spend on fenofibrate 150 MG Oral Capsule [Lipofen]?
In 2023, total Medicare Part D spending on fenofibrate 150 MG Oral Capsule [Lipofen] was $74,983,711, covering 500,170 beneficiaries. The average spend per beneficiary was $149.92.
Read our methodology - how this data is sourced, computed, and verified.