lofexidine 0.18 MG Oral Tablet [Lucemyra]
lofexidine
RxCUI: 2046597
What the CMS Formulary Data Shows for lofexidine 0.18 MG Oral Tablet [Lucemyra]
Per the CMS 2026 Part D formulary file, lofexidine 0.18 MG Oral Tablet [Lucemyra] (RxNorm concept RXCUI 2046597, generic name lofexidine) appears on 4 distinct formulary files spanning 28 Medicare Part D plan offerings - 0.6% of enrollable Part D products, selective placement; verify formulary inclusion before enrolling. Tier placement ranges from Tier 1 to Tier 5, with a cross-plan average of Tier 4.
Real-world access to lofexidine 0.18 MG Oral Tablet [Lucemyra] depends on utilization management as much as tier placement: 0% of covering formularies require prior authorization. 0% require step therapy. 25% apply quantity limits.
Historical spending context from the CMS Medicare Part D Drug Spending Dashboard shows 781 Part D beneficiaries filled lofexidine 0.18 MG Oral Tablet [Lucemyra] in 2023, with total plan-and-beneficiary spending of $3,148,076 and an average per-beneficiary annual cost of $4,030.83. The plan-by-plan detail below lists exactly which PDP and MA-PD contracts carry lofexidine 0.18 MG Oral Tablet [Lucemyra] today.
Coverage Details
- Formularies covering
- 4
- Plans covering
- 28
- Coverage rate
- 0.6%
- Tier range
- Tier 1 – Tier 5
- Average tier
- Tier 4, Non-Preferred
Restrictions
- Prior authorization required
- 0% of formularies
- Step therapy required
- 0% of formularies
- Quantity limits
- 25% of formularies
2023 Medicare Spending
- Beneficiaries
- 781
- Total spending
- $3,148,076
- Avg per beneficiary
- $4,030.83
Tier Distribution Across Plans
Medicare Advantage Plans (MA-PD) Covering lofexidine 0.18 MG Oral Tablet [Lucemyra]
28 Medicare Advantage plans with Part D drug coverage include this drug.
| Plan | Insurer | Tier | PA | Premium | States |
|---|---|---|---|---|---|
| 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 |
| Highmark Wholecare Medicare Assured Ruby (HMO D-SNP) | GATEWAY HEALTH PLAN, INC. | T1 | No | $13.10 | PA |
| Highmark Wholecare Medicare Assured Ruby (HMO D-SNP) | GATEWAY HEALTH PLAN, INC. | T1 | No | $17.60 | PA |
| Highmark Health Options Duals Select (HMO D-SNP) | HIGHMARK BCBSD, INC. | T1 | No | $31.20 | DE |
| Medicare BlueEssential (PPO) | EXCELLUS HEALTH PLAN, INC. | T5 | No | $0 | NY |
| Medicare BlueActive (PPO) | EXCELLUS HEALTH PLAN, INC. | T5 | No | $0 | NY |
| Medicare BlueVital (PPO) | EXCELLUS HEALTH PLAN, INC. | T5 | No | $0 | NY |
| Univera SeniorChoice Basic (HMO) | EXCELLUS HEALTH PLAN, INC. | T5 | No | $0 | NY |
| Univera SeniorChoice Extra (HMO) | EXCELLUS HEALTH PLAN, INC. | T5 | No | $0 | NY |
| Medicare Blue Choice Core (HMO) | EXCELLUS HEALTH PLAN, INC. | T5 | No | $0 | NY |
| Univera Medicare Dual (HMO D-SNP) | EXCELLUS HEALTH PLAN COMMUNITY CARE LLC | T5 | No | $0 | NY |
| Medicare Blue Dual (HMO D-SNP) | EXCELLUS HEALTH PLAN COMMUNITY CARE LLC | T5 | No | $0 | NY |
| CDPHP $0 Medicare Rx (HMO) | CAPITAL DISTRICT PHYSICIANS' HEALTH PLAN, INC. | T5 | No | $0 | NY |
| Univera SeniorChoice Core (PPO) | EXCELLUS HEALTH PLAN, INC. | T5 | No | $33.00 | NY |
| Univera SeniorChoice Advanced (HMO-POS) | EXCELLUS HEALTH PLAN, INC. | T5 | No | $36.90 | NY |
| Medicare BlueClassic (PPO) | EXCELLUS HEALTH PLAN, INC. | T5 | No | $51.00 | NY |
| Univera SeniorChoice Secure (HMO-POS) | EXCELLUS HEALTH PLAN, INC. | T5 | No | $54.90 | NY |
| Medicare BlueBalanced (PPO) | EXCELLUS HEALTH PLAN, INC. | T5 | No | $55.00 | NY |
| Medicare Blue Choice Prime (HMO) | EXCELLUS HEALTH PLAN, INC. | T5 | No | $55.00 | NY |
| Univera SeniorChoice Value Plus (HMO-POS) | EXCELLUS HEALTH PLAN, INC. | T5 | No | $58.60 | NY |
| Medicare BlueEnhanced (PPO) | EXCELLUS HEALTH PLAN, INC. | T5 | No | $70.30 | NY |
| Medicare BluePlus (PPO) | EXCELLUS HEALTH PLAN, INC. | T5 | No | $86.40 | NY |
| CDPHP Clear Rx (HMO) | CAPITAL DISTRICT PHYSICIANS' HEALTH PLAN, INC. | T5 | No | $100.00 | NY |
| CDPHP Choice Rx (HMO) | CAPITAL DISTRICT PHYSICIANS' HEALTH PLAN, INC. | T5 | No | $135.00 | NY |
| Medicare Blue Choice Optimum (HMO-POS) | EXCELLUS HEALTH PLAN, INC. | T5 | No | $146.00 | NY |
Frequently Asked Questions
Is lofexidine 0.18 MG Oral Tablet [Lucemyra] covered by Medicare Part D?
Yes, lofexidine 0.18 MG Oral Tablet [Lucemyra] is covered by 28 Medicare Part D plans (0.6% of all Part D formularies).
What tier is lofexidine 0.18 MG Oral Tablet [Lucemyra] on Medicare Part D plans?
lofexidine 0.18 MG Oral Tablet [Lucemyra] averages Tier 4 across Part D plans, ranging from Tier 1 to Tier 5.
Does lofexidine 0.18 MG Oral Tablet [Lucemyra] require prior authorization?
0% of Part D formularies require prior authorization for lofexidine 0.18 MG Oral Tablet [Lucemyra]. Step therapy: 0%. Quantity limits: 25%.
How much does Medicare spend on lofexidine 0.18 MG Oral Tablet [Lucemyra]?
In 2023, total Medicare Part D spending on lofexidine 0.18 MG Oral Tablet [Lucemyra] was $3,148,076, covering 781 beneficiaries. The average spend per beneficiary was $4,030.83.
Read our methodology - how this data is sourced, computed, and verified.