nalmefene 27 MG/ML Nasal Spray [Opvee]
nalmefene
RxCUI: 2639727
What the CMS Formulary Data Shows for nalmefene 27 MG/ML Nasal Spray [Opvee]
Per the CMS 2026 Part D formulary file, nalmefene 27 MG/ML Nasal Spray [Opvee] (RxNorm concept RXCUI 2639727, generic name nalmefene) appears on 164 distinct formulary files spanning 2,478 Medicare Part D plan offerings - 48.9% of enrollable Part D products, selective placement; verify formulary inclusion before enrolling. Tier placement ranges from Tier 1 to Tier 6, with a cross-plan average of Tier 3.1.
Real-world access to nalmefene 27 MG/ML Nasal Spray [Opvee] depends on utilization management as much as tier placement: 0% of covering formularies require prior authorization. 0% require step therapy. 5.5% apply quantity limits.
Medicare Part D spending dashboard figures are not published for this drug. The plan-by-plan detail below lists exactly which PDP and MA-PD contracts carry nalmefene 27 MG/ML Nasal Spray [Opvee] today.
Coverage Details
- Formularies covering
- 164
- Plans covering
- 2,478
- Coverage rate
- 48.9%
- Tier range
- Tier 1 – Tier 6
- Average tier
- Tier 3, Preferred Brand
Restrictions
- Prior authorization required
- 0% of formularies
- Step therapy required
- 0% of formularies
- Quantity limits
- 5.5% of formularies
Tier Distribution Across Plans
Medicare Advantage Plans (MA-PD) Covering nalmefene 27 MG/ML Nasal Spray [Opvee]
100 Medicare Advantage plans with Part D drug coverage include this drug.
| Plan | Insurer | Tier | PA | Premium | States |
|---|---|---|---|---|---|
| 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 |
| Gold Coast Health Plan Total Care Advantage (HMO D-SNP) | Ventura County Medi-Cal Managed Care Commission | T1 | No | $0 | CA |
| Blue Cross Medicare Advantage Dual Care Plus (HMO D-SNP) | Health Care Service Corporation | T1 | No | $0 | NM |
| Blue Cross MA Dual Care Plus Preferred (PPO D-SNP) | Health Care Service Corporation | T1 | No | $0 | NM |
| Horizon NJ TotalCare (HMO D-SNP) | HORIZON HEALTHCARE OF NEW JERSEY, INC. | T1 | No | $0 | NJ |
| SecureBlue (HMO D-SNP) | HMO Minnesota | T1 | No | $0 | MN |
| NaviCare (HMO D-SNP) | FALLON COMMUNITY HEALTH PLAN | T1 | No | $0 | MA |
| Hamaspik Medicare Choice (HMO D-SNP) | HAMASPIK, INC. | T1 | No | $0 | NY |
| UPMC for Life HMO Premier Rx (HMO) | UPMC HEALTH PLAN, INC. | T1 | No | $0 | PA |
| UPMC for Life Complete Care (HMO D-SNP) | UPMC FOR YOU, INC | T1 | No | $0 | PA |
| UPMC for Life Complete Care (HMO D-SNP) | UPMC FOR YOU, INC | T1 | No | $0 | PA |
| UPMC for Life PPO Premier Rx (PPO) | UPMC HEALTH NETWORK, INC. | T1 | No | $0 | PA |
| UPMC for Life PPO Premier Rx (PPO) | UPMC HEALTH NETWORK, INC. | T1 | No | $0 | PA |
| UPMC for Life PPO Essential Care Rx (PPO) | UPMC HEALTH NETWORK, INC. | T1 | No | $0 | PA |
| UPMC for Life Complete Care (HMO D-SNP) | UPMC HEALTH COVERAGE, INC. | T1 | No | $0 | PA |
| 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 |
| Provider Partners Pennsylvania Community Plan (HMO I-SNP) | PROVIDER PARTNERS HEALTH PLAN OF PENNSYLVANIA, INC | T1 | No | $0 | PA |
| Provider Partners North Carolina Community Plan (HMO I-SNP) | PROVIDER PARTNERS HEALTH PLAN OF NORTH CAROLINA | T1 | No | $0 | NC |
| Provider Partners Indiana Community Plan (HMO I-SNP) | PROVIDER PARTNERS HEALTH PLAN OF INDIANA | T1 | No | $0 | IN |
| Provider Partners Maryland Community Plan (HMO I-SNP) | PROVIDER PARTNERS HEALTH PLAN, INC. | T1 | No | $0 | MD |
| Provider Partners Missouri Community Plan (HMO I-SNP) | PROVIDER PARTNERS HEALTH PLAN OF MISSOURI, INC. | T1 | No | $0 | MO |
| 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 |
| Tufts Health One Care (HMO D-SNP) | TUFTS HEALTH PUBLIC PLANS, INC. | T1 | No | $0 | MA |
| Tufts Health One Care CW (HMO D-SNP) | TUFTS HEALTH PUBLIC PLANS, INC. | T1 | No | $0 | MA |
| Tufts Health Plan Senior Care Options (HMO D-SNP) | TUFTS ASSOCIATED HEALTH MAINTENANCE ORGANIZATION | T1 | No | $0 | MA |
| Tufts Health Plan Senior Care Options CW (HMO D-SNP) | TUFTS ASSOCIATED HEALTH MAINTENANCE ORGANIZATION | T1 | No | $0 | MA |
| UPMC for Life HMO Rx Choice (HMO) | UPMC HEALTH PLAN, INC. | T1 | No | $3.90 | OH, PA |
| 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 |
| Blue Cross Medicare Advantage Dual Care Plus (HMO D-SNP) | HCSC INSURANCE SERVICES COMPANY | T1 | No | $4.80 | TX |
| Provider Partners Texas Advantage Plan (HMO I-SNP) | PROVIDER PARTNERS HEALTH PLAN OF TEXAS, INC. | T1 | No | $4.80 | TX |
| Blue Cross Medicare Advantage Dual Care Plus (HMO D-SNP) | GHS INSURANCE COMPANY | T1 | No | $5.00 | OK |
| Senior Care (HMO I-SNP) | ALIGN SENIOR CARE MI, LLC | T1 | No | $8.80 | MI |
Frequently Asked Questions
Is nalmefene 27 MG/ML Nasal Spray [Opvee] covered by Medicare Part D?
Yes, nalmefene 27 MG/ML Nasal Spray [Opvee] is covered by 2,478 Medicare Part D plans (48.9% of all Part D formularies).
What tier is nalmefene 27 MG/ML Nasal Spray [Opvee] on Medicare Part D plans?
nalmefene 27 MG/ML Nasal Spray [Opvee] averages Tier 3.1 across Part D plans, ranging from Tier 1 to Tier 6.
Does nalmefene 27 MG/ML Nasal Spray [Opvee] require prior authorization?
0% of Part D formularies require prior authorization for nalmefene 27 MG/ML Nasal Spray [Opvee]. Step therapy: 0%. Quantity limits: 5.5%.
Read our methodology - how this data is sourced, computed, and verified.