simvastatin 5 MG Oral Tablet
simvastatin
RxCUI: 312962
What the CMS Formulary Data Shows for simvastatin 5 MG Oral Tablet
Per the CMS 2026 Part D formulary file, simvastatin 5 MG Oral Tablet (RxNorm concept RXCUI 312962, generic name simvastatin) appears on 330 distinct formulary files spanning 5,067 Medicare Part D plan offerings - 100% of enrollable Part D products, near-universal placement. Tier placement ranges from Tier 1 to Tier 6, with a cross-plan average of Tier 2.3.
Real-world access to simvastatin 5 MG Oral Tablet depends on utilization management as much as tier placement: 0% of covering formularies require prior authorization. 0% require step therapy. 52.7% apply quantity limits.
Historical spending context from the CMS Medicare Part D Drug Spending Dashboard shows 3,917,152 Part D beneficiaries filled simvastatin 5 MG Oral Tablet in 2023, with total plan-and-beneficiary spending of $172,937,895 and an average per-beneficiary annual cost of $44.15. The plan-by-plan detail below lists exactly which PDP and MA-PD contracts carry simvastatin 5 MG Oral Tablet today.
Coverage Details
- Formularies covering
- 330
- Plans covering
- 5,067
- Coverage rate
- 100%
- Tier range
- Tier 1 – Tier 6
- Average tier
- Tier 2, Generic
Restrictions
- Prior authorization required
- 0% of formularies
- Step therapy required
- 0% of formularies
- Quantity limits
- 52.7% of formularies
2023 Medicare Spending
- Beneficiaries
- 3,917,152
- Total spending
- $172,937,895
- Avg per beneficiary
- $44.15
Tier Distribution Across Plans
Standalone Drug Plans (PDP) Covering simvastatin 5 MG Oral Tablet
2 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 | T1 | No | No | $0 | - |
| AARP Medicare Rx Preferred from UHC (PDP) | UNITEDHEALTHCARE INS. CO. & UHC INS. CO. OF NY | T1 | No | No | $0 | - |
Medicare Advantage Plans (MA-PD) Covering simvastatin 5 MG Oral Tablet
98 Medicare Advantage plans with Part D drug coverage include this drug.
Frequently Asked Questions
Is simvastatin 5 MG Oral Tablet covered by Medicare Part D?
Yes, simvastatin 5 MG Oral Tablet is covered by 5,067 Medicare Part D plans (100% of all Part D formularies).
What tier is simvastatin 5 MG Oral Tablet on Medicare Part D plans?
simvastatin 5 MG Oral Tablet averages Tier 2.3 across Part D plans, ranging from Tier 1 to Tier 6.
Does simvastatin 5 MG Oral Tablet require prior authorization?
0% of Part D formularies require prior authorization for simvastatin 5 MG Oral Tablet. Step therapy: 0%. Quantity limits: 52.7%.
How much does Medicare spend on simvastatin 5 MG Oral Tablet?
In 2023, total Medicare Part D spending on simvastatin 5 MG Oral Tablet was $172,937,895, covering 3,917,152 beneficiaries. The average spend per beneficiary was $44.15.
Read our methodology - how this data is sourced, computed, and verified.