Medicare Part D coverage · omadacycline · RxCUI 2059292
omadacycline 100 MG Injection [Nuzyra]
Per the CMS 2026 Part D formulary file, omadacycline 100 MG Injection [Nuzyra] is covered by 2,637 Medicare Part D plans (52.2% of enrollable products), averaging Tier 4.3, with prior authorization required on 13.6% of covering formularies.
- 52.2%
- Plan coverage
- 2,637
- Plans covering
- T4.3
- Avg tier
- 13.6%
- Prior auth required
What the CMS Formulary Data Shows for omadacycline 100 MG Injection [Nuzyra]
Per the CMS 2026 Part D formulary file, omadacycline 100 MG Injection [Nuzyra] (RxNorm concept RXCUI 2059292, generic name omadacycline) appears on 88 distinct formulary files spanning 2,637 Medicare Part D plan offerings - 52.2% of enrollable Part D products, mid-range placement; shopping across contracts changes access. Tier placement ranges from Tier 1 to Tier 6, with a cross-plan average of Tier 4.3.
Real-world access to omadacycline 100 MG Injection [Nuzyra] depends on utilization management as much as tier placement: 13.6% of covering formularies require prior authorization. 0% require step therapy. 1.1% apply quantity limits.
Historical spending context from the CMS Medicare Part D Drug Spending Dashboard shows 3,687 Part D beneficiaries filled omadacycline 100 MG Injection [Nuzyra] in 2023, with total plan-and-beneficiary spending of $73,196,529 and an average per-beneficiary annual cost of $19,852.60. The plan-by-plan detail below lists exactly which PDP and MA-PD contracts carry omadacycline 100 MG Injection [Nuzyra] today.
Coverage Details
- Formularies covering
- 88
- Plans covering
- 2,637
- Coverage rate
- 52.2%
- Tier range
- Tier 1 – Tier 6
- Average tier
- Tier 4, Non-Preferred
Restrictions
- Prior authorization required
- 13.6% of formularies
- Step therapy required
- 0% of formularies
- Quantity limits
- 1.1% of formularies
2023 Medicare Spending
- Beneficiaries
- 3,687
- Total spending
- $73,196,529
- Avg per beneficiary
- $19,852.60
Tier Distribution Across Plans
Standalone Drug Plans (PDP) Covering omadacycline 100 MG Injection [Nuzyra]
5 standalone prescription drug plans include this drug.
| Plan | Insurer | Tier | PA | ST | Premium | States |
|---|---|---|---|---|---|---|
| AARP Medicare Rx Preferred from UHC (PDP) | Unitedhealthcare INS. Co. & UHC INS. Co. OF NY | T5 | Yes | No | $0 | - |
| AARP Medicare Rx Preferred from UHC (PDP) | Unitedhealthcare INS. Co. & UHC INS. Co. OF NY | T5 | Yes | No | $0 | - |
| AARP Medicare Rx Saver from UHC (PDP) | Unitedhealthcare INS. Co. & UHC INS. Co. OF NY | T5 | Yes | No | $0 | - |
| AARP Medicare Rx Saver from UHC (PDP) | Unitedhealthcare INS. Co. & UHC INS. Co. OF NY | T5 | Yes | No | $0 | - |
| AARP Medicare Rx Saver from UHC (PDP) | Unitedhealthcare INS. Co. & UHC INS. Co. OF NY | T5 | Yes | No | $0 | - |
Medicare Advantage Plans (MA-PD) Covering omadacycline 100 MG Injection [Nuzyra]
95 Medicare Advantage plans with Part D drug coverage include this drug.
| Plan | Insurer | Tier | PA | Premium | States |
|---|---|---|---|---|---|
| Florida Complete Care-Duals VIP (HMO-POS D-SNP) | Hpmp OF Florida, Inc. | T1 | No | $0 | FL |
| Mercy Care Advantage (HMO D-SNP) | Mercy Care | T1 | No | $0 | AZ |
| Mercy Care Advantage (HMO D-SNP) | Mercy Care | T1 | No | $0 | AZ |
| Mercy Care Advantage (HMO D-SNP) | Mercy Care | T1 | No | $0 | AZ |
| Elderplan Plus Long-Term Care (HMO-POS D-SNP) | Elderplan, Inc. | T1 | No | $0 | NY |
| Health Choice Pathway (HMO D-SNP) | Health Choice Arizona, Inc. | T1 | No | $0 | AZ |
| Healthfirst CompleteCare (HMO D-SNP) | Healthfirst Health Plan, Inc. | T1 | No | $0 | NY |
| IMCare Classic (HMO D-SNP) | Itasca Medical Care | T1 | No | $0 | MN |
| Johns Hopkins Advantage MD D-SNP (HMO D-SNP) | Hopkins Health Advantage, Inc. | T1 | No | $0 | MD |
| MetroPlus UltraCare (HMO D-SNP) | Metroplus Health Plan, Inc. | T1 | No | $0 | NY |
| Senior Whole Health SCO (HMO D-SNP) | Senior Whole Health, LLC | T1 | No | $0 | MA |
| Senior Whole Health SCO NHC (HMO D-SNP) | Senior Whole Health, LLC | T1 | No | $0 | MA |
| Molina One Care (HMO D-SNP) | Senior Whole Health, LLC | T1 | No | $0 | MA |
| NaviCare (HMO D-SNP) | Fallon Community Health Plan | T1 | No | $0 | MA |
| CCA One Care (HMO D-SNP) | Commonwealth Care Alliance, Inc. | T1 | No | $0 | MA |
| CCA Senior Care Options (HMO D-SNP) | Commonwealth Care Alliance, Inc. | T1 | No | $0 | MA |
| 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 |
| Florida Complete Care (HMO I-SNP) | Hpmp OF Florida, Inc. | T1 | No | $4.80 | FL |
| Florida Complete Care- In The Community (HMO-POS I-SNP) | Hpmp OF Florida, Inc. | T1 | No | $4.80 | FL |
Show the next 30 plans
Showing top 50 of 95 plans.
Frequently Asked Questions
Is omadacycline 100 MG Injection [Nuzyra] covered by Medicare Part D?
Yes, omadacycline 100 MG Injection [Nuzyra] is covered by 2,637 Medicare Part D plans (52.2% of all Part D formularies).
What tier is omadacycline 100 MG Injection [Nuzyra] on Medicare Part D plans?
omadacycline 100 MG Injection [Nuzyra] averages Tier 4.3 across Part D plans, ranging from Tier 1 to Tier 6.
Does omadacycline 100 MG Injection [Nuzyra] require prior authorization?
13.6% of Part D formularies require prior authorization for omadacycline 100 MG Injection [Nuzyra]. Step therapy: 0%. Quantity limits: 1.1%.
How much does Medicare spend on omadacycline 100 MG Injection [Nuzyra]?
In 2023, total Medicare Part D spending on omadacycline 100 MG Injection [Nuzyra] was $73,196,529, covering 3,687 beneficiaries. The average spend per beneficiary was $19,852.60.
Read our methodology - how this data is sourced, computed, and verified.
Nationwide similar Part D drugs
Data-derived peers across the CMS Part D formulary extract: nearest average tier placement and nearest prior-authorization rate. Not therapeutic alternatives or same-generic strengths.
Closest average formulary tier
- 1 ML leuprolide acetate 7.5 MG/ML Prefilled Syringe [Lupron] T4.3
- 3 ML icatibant 10 MG/ML Prefilled Syringe [Sajazir] T4.3
- sacrosidase 8500 UNT/ML Oral Solution [Sucraid] T4.3
- deflazacort 22.75 MG/ML Oral Suspension T4.3
- {28 (alpelisib 125 MG Oral Tablet [Vijoice]) } Pack [Vijoice 125 MG 28 Day] T4.3
- 0.5 ML interferon beta-1a 0.044 MG/ML Auto-Injector [Rebif] T4.3
Similar prior-authorization rate
- pilocarpine hydrochloride 12.5 MG/ML Ophthalmic Solution 13.6% PA
- naloxegol 12.5 MG Oral Tablet [Movantik] 13.6% PA
- disopyramide 100 MG Oral Capsule 13.6% PA
- loxapine 50 MG Oral Capsule 13.7% PA
- loxapine 25 MG Oral Capsule 13.7% PA
- trifluoperazine 1 MG Oral Tablet 13.7% PA