Medicare Part D coverage · sildenafil · RxCUI 1307427
sildenafil 10 MG/ML Oral Suspension
Per the CMS 2026 Part D formulary file, sildenafil 10 MG/ML Oral Suspension is covered by 213 Medicare Part D plans (4.2% of enrollable products), averaging Tier 3.7, with prior authorization required on 100% of covering formularies.
- 4.2%
- Plan coverage
- 213
- Plans covering
- T3.7
- Avg tier
- 100%
- Prior auth required
What the CMS Formulary Data Shows for sildenafil 10 MG/ML Oral Suspension
Per the CMS 2026 Part D formulary file, sildenafil 10 MG/ML Oral Suspension (RxNorm concept RXCUI 1307427, generic name sildenafil) appears on 30 distinct formulary files spanning 213 Medicare Part D plan offerings - 4.2% 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 3.7.
Real-world access to sildenafil 10 MG/ML Oral Suspension depends on utilization management as much as tier placement: 100% of covering formularies require prior authorization. 0% require step therapy. 66.7% apply quantity limits.
Historical spending context from the CMS Medicare Part D Drug Spending Dashboard shows 253,277 Part D beneficiaries filled sildenafil 10 MG/ML Oral Suspension in 2023, with total plan-and-beneficiary spending of $44,685,696 and an average per-beneficiary annual cost of $176.43. The plan-by-plan detail below lists exactly which PDP and MA-PD contracts carry sildenafil 10 MG/ML Oral Suspension today.
Coverage Details
- Formularies covering
- 30
- Plans covering
- 213
- Coverage rate
- 4.2%
- Tier range
- Tier 1 – Tier 6
- Average tier
- Tier 4, Non-Preferred
Restrictions
- Prior authorization required
- 100% of formularies
- Step therapy required
- 0% of formularies
- Quantity limits
- 66.7% of formularies
2023 Medicare Spending
- Beneficiaries
- 253,277
- Total spending
- $44,685,696
- Avg per beneficiary
- $176.43
Tier Distribution Across Plans
Medicare Advantage Plans (MA-PD) Covering sildenafil 10 MG/ML Oral Suspension
100 Medicare Advantage plans with Part D drug coverage include this drug.
Show the next 30 plans
Showing top 50 of 100 plans.
Frequently Asked Questions
Is sildenafil 10 MG/ML Oral Suspension covered by Medicare Part D?
Yes, sildenafil 10 MG/ML Oral Suspension is covered by 213 Medicare Part D plans (4.2% of all Part D formularies).
What tier is sildenafil 10 MG/ML Oral Suspension on Medicare Part D plans?
sildenafil 10 MG/ML Oral Suspension averages Tier 3.7 across Part D plans, ranging from Tier 1 to Tier 6.
Does sildenafil 10 MG/ML Oral Suspension require prior authorization?
100% of Part D formularies require prior authorization for sildenafil 10 MG/ML Oral Suspension. Step therapy: 0%. Quantity limits: 66.7%.
How much does Medicare spend on sildenafil 10 MG/ML Oral Suspension?
In 2023, total Medicare Part D spending on sildenafil 10 MG/ML Oral Suspension was $44,685,696, covering 253,277 beneficiaries. The average spend per beneficiary was $176.43.
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
- Modified 24 HR metformin hydrochloride 500 MG Extended Release Oral Tablet T3.7
- ergotamine tartrate 2 MG Sublingual Tablet [Ergomar] T3.7
- somatropin 12 MG Cartridge [Humatrope] T3.7
- baclofen 5 MG/ML Oral Suspension T3.7
- nitrofurantoin 10 MG/ML Oral Suspension T3.7
- dalbavancin 500 MG Injection [Dalvance] T3.7
Similar prior-authorization rate
- azathioprine 50 MG Oral Tablet 100% PA
- 0.5 ML hepatitis B surface antigen vaccine 0.04 MG/ML Prefilled Syringe [Heplisav-B] 100% PA
- 0.5 ML hepatitis B surface antigen vaccine 0.02 MG/ML Prefilled Syringe [Engerix-B] 100% PA
- 1 ML hepatitis B surface antigen vaccine 0.02 MG/ML Prefilled Syringe [Engerix-B] 100% PA
- sodium phenylbutyrate 0.483 MG/MG Oral Pellet [Pheburane] 100% PA
- sotagliflozin 200 MG Oral Tablet [Inpefa] 100% PA