misoprostol 0.2 MG Oral Tablet [Cytotec]
misoprostol
RxCUI: 104098
What the CMS Formulary Data Shows for misoprostol 0.2 MG Oral Tablet [Cytotec]
Per the CMS 2026 Part D formulary file, misoprostol 0.2 MG Oral Tablet [Cytotec] (RxNorm concept RXCUI 104098, generic name misoprostol) appears on 2 distinct formulary files spanning 8 Medicare Part D plan offerings - 0.2% of enrollable Part D products, selective placement; verify formulary inclusion before enrolling. Tier placement ranges from Tier 1 to Tier 4, with a cross-plan average of Tier 2.5.
Real-world access to misoprostol 0.2 MG Oral Tablet [Cytotec] 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 47,809 Part D beneficiaries filled misoprostol 0.2 MG Oral Tablet [Cytotec] in 2023, with total plan-and-beneficiary spending of $4,396,126 and an average per-beneficiary annual cost of $91.95. The plan-by-plan detail below lists exactly which PDP and MA-PD contracts carry misoprostol 0.2 MG Oral Tablet [Cytotec] today.
Coverage Details
- Formularies covering
- 2
- Plans covering
- 8
- Coverage rate
- 0.2%
- Tier range
- Tier 1 – Tier 4
- Average tier
- Tier 3, Preferred Brand
Restrictions
- Prior authorization required
- 0% of formularies
- Step therapy required
- 0% of formularies
- Quantity limits
- 0% of formularies
2023 Medicare Spending
- Beneficiaries
- 47,809
- Total spending
- $4,396,126
- Avg per beneficiary
- $91.95
Tier Distribution Across Plans
Medicare Advantage Plans (MA-PD) Covering misoprostol 0.2 MG Oral Tablet [Cytotec]
8 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 |
| Óptimo Plus (PPO) | TRIPLE S ADVANTAGE, INC. | T4 | No | $0 | PR |
| Contigo Plus (HMO C-SNP) | TRIPLE S ADVANTAGE, INC. | T4 | No | $0 | PR |
| Brillante (HMO-POS) | TRIPLE S ADVANTAGE, INC. | T4 | No | $0 | PR |
| Enlace Plus (HMO) | TRIPLE S ADVANTAGE, INC. | T4 | No | $0 | PR |
| ContigoEnMente (HMO C-SNP) | TRIPLE S ADVANTAGE, INC. | T4 | No | $0 | PR |
| Ahorro Plus (HMO) | TRIPLE S ADVANTAGE, INC. | T4 | No | $0 | PR |
Frequently Asked Questions
Is misoprostol 0.2 MG Oral Tablet [Cytotec] covered by Medicare Part D?
Yes, misoprostol 0.2 MG Oral Tablet [Cytotec] is covered by 8 Medicare Part D plans (0.2% of all Part D formularies).
What tier is misoprostol 0.2 MG Oral Tablet [Cytotec] on Medicare Part D plans?
misoprostol 0.2 MG Oral Tablet [Cytotec] averages Tier 2.5 across Part D plans, ranging from Tier 1 to Tier 4.
Does misoprostol 0.2 MG Oral Tablet [Cytotec] require prior authorization?
0% of Part D formularies require prior authorization for misoprostol 0.2 MG Oral Tablet [Cytotec]. Step therapy: 0%. Quantity limits: 0%.
How much does Medicare spend on misoprostol 0.2 MG Oral Tablet [Cytotec]?
In 2023, total Medicare Part D spending on misoprostol 0.2 MG Oral Tablet [Cytotec] was $4,396,126, covering 47,809 beneficiaries. The average spend per beneficiary was $91.95.
Read our methodology - how this data is sourced, computed, and verified.