nitroglycerin 0.004 MG/MG Rectal Ointment [Rectiv]
nitroglycerin
RxCUI: 1114470
What the CMS Formulary Data Shows for nitroglycerin 0.004 MG/MG Rectal Ointment [Rectiv]
Per the CMS 2026 Part D formulary file, nitroglycerin 0.004 MG/MG Rectal Ointment [Rectiv] (RxNorm concept RXCUI 1114470, generic name nitroglycerin) appears on 9 distinct formulary files spanning 52 Medicare Part D plan offerings - 1% 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 3.3.
Real-world access to nitroglycerin 0.004 MG/MG Rectal Ointment [Rectiv] depends on utilization management as much as tier placement: 0% of covering formularies require prior authorization. 0% require step therapy. 77.8% apply quantity limits.
Historical spending context from the CMS Medicare Part D Drug Spending Dashboard shows 1,348,161 Part D beneficiaries filled nitroglycerin 0.004 MG/MG Rectal Ointment [Rectiv] in 2023, with total plan-and-beneficiary spending of $46,051,994 and an average per-beneficiary annual cost of $34.16. The plan-by-plan detail below lists exactly which PDP and MA-PD contracts carry nitroglycerin 0.004 MG/MG Rectal Ointment [Rectiv] today.
Coverage Details
- Formularies covering
- 9
- Plans covering
- 52
- Coverage rate
- 1%
- 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
- 77.8% of formularies
2023 Medicare Spending
- Beneficiaries
- 1,348,161
- Total spending
- $46,051,994
- Avg per beneficiary
- $34.16
Tier Distribution Across Plans
Medicare Advantage Plans (MA-PD) Covering nitroglycerin 0.004 MG/MG Rectal Ointment [Rectiv]
52 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 |
| 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 |
| Hamaspik Medicare Select (HMO D-SNP) | HAMASPIK, INC. | T1 | No | $34.50 | NY |
| Health New England Medicare Compass (PPO) | HEALTH NEW ENGLAND, INC. | T4 | No | $0 | MA |
| Health New England Medicare Value (HMO) | HEALTH NEW ENGLAND, INC. | T4 | No | $0 | MA |
| Health First Rewards H1099-014 (HMO) | HEALTH FIRST HEALTH PLANS | T4 | No | $0 | FL |
| Health First SunSaver H1099-016 (HMO) | HEALTH FIRST HEALTH PLANS | T4 | No | $0 | FL |
| Health First Complete Care H1099-023 (HMO) | HEALTH FIRST HEALTH PLANS | T4 | No | $0 | FL |
| Health First Emerald Plus H1099-024 (HMO) | HEALTH FIRST HEALTH PLANS | T4 | No | $0 | FL |
| Health First Premier Access H1099-025 (HMO-POS) | HEALTH FIRST HEALTH PLANS | T4 | No | $0 | FL |
| Health First Emerald Plus H1099-026 (HMO) | HEALTH FIRST HEALTH PLANS | T4 | No | $0 | FL |
| Health First Premier Access H1099-027 (HMO-POS) | HEALTH FIRST HEALTH PLANS | T4 | No | $0 | FL |
| Health First Emerald Plus H1099-028 (HMO) | HEALTH FIRST HEALTH PLANS | T4 | No | $0 | FL |
| 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 |
| Prominence Plus (HMO) | PROMINENCE HEALTHFIRST | T4 | No | $0 | NV |
| Prominence Plus (HMO) | PROMINENCE HEALTHFIRST | T4 | No | $0 | NV |
| Prominence Dual (HMO D-SNP) | PROMINENCE HEALTHFIRST | T4 | No | $0 | NV |
| Prominence Dual (HMO D-SNP) | PROMINENCE HEALTHFIRST | T4 | No | $0 | NV |
| Prominence Giveback (HMO) | PROMINENCE HEALTHFIRST | T4 | No | $0 | NV |
| Prominence Plus (HMO) | PROMINENCE HEALTHFIRST OF FLORIDA INC | T4 | No | $0 | FL |
| Prominence Giveback (HMO) | PROMINENCE HEALTHFIRST OF FLORIDA INC | T4 | No | $0 | FL |
| Prominence Plus (HMO) | PROMINENCE HEALTHFIRST OF TEXAS | T4 | No | $0 | TX |
| Prominence Plus (HMO) | PROMINENCE HEALTHFIRST OF TEXAS | T4 | No | $0 | TX |
| Prominence Dual (HMO D-SNP) | PROMINENCE HEALTHFIRST OF TEXAS | T4 | No | $0 | TX |
| Prominence Extra Help (HMO) | PROMINENCE HEALTHFIRST OF TEXAS | T4 | No | $0 | TX |
| Prominence Beyond (HMO) | PROMINENCE HEALTHFIRST OF TEXAS | T4 | No | $0 | TX |
| Prominence Giveback (HMO) | PROMINENCE HEALTHFIRST OF TEXAS | T4 | No | $0 | TX |
| Prominence Giveback (HMO) | PROMINENCE HEALTHFIRST OF TEXAS | T4 | No | $0 | TX |
| Prominence Dual (HMO D-SNP) | PROMINENCE HEALTHFIRST OF TEXAS | T4 | No | $0 | TX |
| Prominence Beyond (HMO-POS) | PROMINENCE HEALTHFIRST OF TEXAS | T4 | No | $0 | TX |
| Prominence Dual (HMO D-SNP) | PROMINENCE HEALTHFIRST OF FLORIDA INC | T4 | No | $0 | FL |
| Prominence Diabetes and Heart Giveback (HMO C-SNP) | PROMINENCE HEALTHFIRST | T4 | No | $0 | NV |
| Prominence Diabetes and Heart Giveback (HMO C-SNP) | PROMINENCE HEALTHFIRST OF FLORIDA INC | T4 | No | $0 | FL |
| Prominence Diabetes and Heart Giveback (HMO C-SNP) | PROMINENCE HEALTHFIRST OF TEXAS | T4 | No | $0 | TX |
| Prominence Diabetes and Heart Care Plus (HMO C-SNP) | PROMINENCE HEALTHFIRST OF TEXAS | T4 | No | $0 | TX |
| Prominence Diabetes and Heart Giveback (HMO C-SNP) | PROMINENCE HEALTHFIRST OF TEXAS | T4 | No | $0 | TX |
| Prominence Extra Help (HMO) | PROMINENCE HEALTHFIRST | T4 | No | $4.20 | NV |
| Prominence Extra Help (HMO) | PROMINENCE HEALTHFIRST OF FLORIDA INC | T4 | No | $4.80 | FL |
| Prominence Extra Help (HMO) | PROMINENCE HEALTHFIRST OF TEXAS | T4 | No | $4.80 | TX |
| Prominence Extra Help (HMO) | PROMINENCE HEALTHFIRST | T4 | No | $9.50 | NV |
| Health First Value H1099-006 (HMO) | HEALTH FIRST HEALTH PLANS | T4 | No | $15.00 | FL |
| Health New England Medicare Premium (HMO) | HEALTH NEW ENGLAND, INC. | T4 | No | $15.80 | MA |
Frequently Asked Questions
Is nitroglycerin 0.004 MG/MG Rectal Ointment [Rectiv] covered by Medicare Part D?
Yes, nitroglycerin 0.004 MG/MG Rectal Ointment [Rectiv] is covered by 52 Medicare Part D plans (1% of all Part D formularies).
What tier is nitroglycerin 0.004 MG/MG Rectal Ointment [Rectiv] on Medicare Part D plans?
nitroglycerin 0.004 MG/MG Rectal Ointment [Rectiv] averages Tier 3.3 across Part D plans, ranging from Tier 1 to Tier 4.
Does nitroglycerin 0.004 MG/MG Rectal Ointment [Rectiv] require prior authorization?
0% of Part D formularies require prior authorization for nitroglycerin 0.004 MG/MG Rectal Ointment [Rectiv]. Step therapy: 0%. Quantity limits: 77.8%.
How much does Medicare spend on nitroglycerin 0.004 MG/MG Rectal Ointment [Rectiv]?
In 2023, total Medicare Part D spending on nitroglycerin 0.004 MG/MG Rectal Ointment [Rectiv] was $46,051,994, covering 1,348,161 beneficiaries. The average spend per beneficiary was $34.16.
Read our methodology - how this data is sourced, computed, and verified.