penciclovir 10 MG/ML Topical Cream [Denavir]
penciclovir
RxCUI: 211343
What the CMS Formulary Data Shows for penciclovir 10 MG/ML Topical Cream [Denavir]
Per the CMS 2026 Part D formulary file, penciclovir 10 MG/ML Topical Cream [Denavir] (RxNorm concept RXCUI 211343, generic name penciclovir) appears on 3 distinct formulary files spanning 14 Medicare Part D plan offerings - 0.3% 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.
Real-world access to penciclovir 10 MG/ML Topical Cream [Denavir] depends on utilization management as much as tier placement: 0% of covering formularies require prior authorization. 66.7% require step therapy. 33.3% apply quantity limits.
Historical spending context from the CMS Medicare Part D Drug Spending Dashboard shows 3,267 Part D beneficiaries filled penciclovir 10 MG/ML Topical Cream [Denavir] in 2023, with total plan-and-beneficiary spending of $3,183,178 and an average per-beneficiary annual cost of $974.34. The plan-by-plan detail below lists exactly which PDP and MA-PD contracts carry penciclovir 10 MG/ML Topical Cream [Denavir] today.
Coverage Details
- Formularies covering
- 3
- Plans covering
- 14
- Coverage rate
- 0.3%
- Tier range
- Tier 1 – Tier 4
- Average tier
- Tier 3, Preferred Brand
Restrictions
- Prior authorization required
- 0% of formularies
- Step therapy required
- 66.7% of formularies
- Quantity limits
- 33.3% of formularies
2023 Medicare Spending
- Beneficiaries
- 3,267
- Total spending
- $3,183,178
- Avg per beneficiary
- $974.34
Tier Distribution Across Plans
Medicare Advantage Plans (MA-PD) Covering penciclovir 10 MG/ML Topical Cream [Denavir]
14 Medicare Advantage plans with Part D drug coverage include this drug.
| Plan | Insurer | Tier | PA | Premium | States |
|---|---|---|---|---|---|
| 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 |
| Presbyterian Senior Care Plan 2 with Rx (HMO) | PRESBYTERIAN HEALTH PLAN | T4 | No | $0 | NM |
| Presbyterian Dual Plus (HMO D-SNP) | PRESBYTERIAN HEALTH PLAN | T4 | No | $0 | NM |
| Presbyterian Senior Care Extra Health Plan with Rx (HMO) | PRESBYTERIAN HEALTH PLAN | T4 | No | $0 | NM |
| 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 |
| Presbyterian Senior Care Plan 3 with Rx (HMO) | PRESBYTERIAN HEALTH PLAN | T4 | No | $65.80 | NM |
Frequently Asked Questions
Is penciclovir 10 MG/ML Topical Cream [Denavir] covered by Medicare Part D?
Yes, penciclovir 10 MG/ML Topical Cream [Denavir] is covered by 14 Medicare Part D plans (0.3% of all Part D formularies).
What tier is penciclovir 10 MG/ML Topical Cream [Denavir] on Medicare Part D plans?
penciclovir 10 MG/ML Topical Cream [Denavir] averages Tier 3 across Part D plans, ranging from Tier 1 to Tier 4.
Does penciclovir 10 MG/ML Topical Cream [Denavir] require prior authorization?
0% of Part D formularies require prior authorization for penciclovir 10 MG/ML Topical Cream [Denavir]. Step therapy: 66.7%. Quantity limits: 33.3%.
How much does Medicare spend on penciclovir 10 MG/ML Topical Cream [Denavir]?
In 2023, total Medicare Part D spending on penciclovir 10 MG/ML Topical Cream [Denavir] was $3,183,178, covering 3,267 beneficiaries. The average spend per beneficiary was $974.34.
Read our methodology - how this data is sourced, computed, and verified.