somatropin 10 MG/ML Injectable Solution [Zomacton]
somatropin
RxCUI: 1648160
What the CMS Formulary Data Shows for somatropin 10 MG/ML Injectable Solution [Zomacton]
Per the CMS 2026 Part D formulary file, somatropin 10 MG/ML Injectable Solution [Zomacton] (RxNorm concept RXCUI 1648160, generic name somatropin) appears on 5 distinct formulary files spanning 7 Medicare Part D plan offerings - 0.1% 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 2.4.
Real-world access to somatropin 10 MG/ML Injectable Solution [Zomacton] depends on utilization management as much as tier placement: 100% of covering formularies require prior authorization. 0% require step therapy. 0% apply quantity limits.
Historical spending context from the CMS Medicare Part D Drug Spending Dashboard shows 1,572 Part D beneficiaries filled somatropin 10 MG/ML Injectable Solution [Zomacton] in 2023, with total plan-and-beneficiary spending of $27,196,427 and an average per-beneficiary annual cost of $17,300.53. The plan-by-plan detail below lists exactly which PDP and MA-PD contracts carry somatropin 10 MG/ML Injectable Solution [Zomacton] today.
Coverage Details
- Formularies covering
- 5
- Plans covering
- 7
- Coverage rate
- 0.1%
- Tier range
- Tier 1 – Tier 4
- Average tier
- Tier 2, Generic
Restrictions
- Prior authorization required
- 100% of formularies
- Step therapy required
- 0% of formularies
- Quantity limits
- 0% of formularies
2023 Medicare Spending
- Beneficiaries
- 1,572
- Total spending
- $27,196,427
- Avg per beneficiary
- $17,300.53
Tier Distribution Across Plans
Medicare Advantage Plans (MA-PD) Covering somatropin 10 MG/ML Injectable Solution [Zomacton]
7 Medicare Advantage plans with Part D drug coverage include this drug.
| Plan | Insurer | Tier | PA | Premium | States |
|---|---|---|---|---|---|
| Mass General Brigham SCO (HMO D-SNP) | MASS GENERAL BRIGHAM HEALTH PLAN, INC | T1 | Yes | $0 | MA |
| Mass General Brigham One Care (HMO D-SNP) | MASS GENERAL BRIGHAM HEALTH PLAN, INC | T1 | Yes | $0 | MA |
| CalOptima Health OneCare Complete (HMO D-SNP) | ORANGE COUNTY HEALTH AUTHORITY | T2 | Yes | $0 | CA |
| Mass General Brigham Advantage (PPO) | Mass General Brigham Health Plan, Inc. | T4 | Yes | $0 | MA |
| Mass General Brigham Advantage Secure (HMO-POS) | Mass General Brigham Health Plan, Inc. | T4 | Yes | $62.00 | MA |
| Mass General Brigham Advantage Premier (PPO) | Mass General Brigham Health Plan, Inc. | T4 | Yes | $79.70 | MA |
| Mass General Brigham Advantage Signature (PPO) | Mass General Brigham Health Plan, Inc. | T4 | Yes | $147.20 | MA |
Frequently Asked Questions
Is somatropin 10 MG/ML Injectable Solution [Zomacton] covered by Medicare Part D?
Yes, somatropin 10 MG/ML Injectable Solution [Zomacton] is covered by 7 Medicare Part D plans (0.1% of all Part D formularies).
What tier is somatropin 10 MG/ML Injectable Solution [Zomacton] on Medicare Part D plans?
somatropin 10 MG/ML Injectable Solution [Zomacton] averages Tier 2.4 across Part D plans, ranging from Tier 1 to Tier 4.
Does somatropin 10 MG/ML Injectable Solution [Zomacton] require prior authorization?
100% of Part D formularies require prior authorization for somatropin 10 MG/ML Injectable Solution [Zomacton]. Step therapy: 0%. Quantity limits: 0%.
How much does Medicare spend on somatropin 10 MG/ML Injectable Solution [Zomacton]?
In 2023, total Medicare Part D spending on somatropin 10 MG/ML Injectable Solution [Zomacton] was $27,196,427, covering 1,572 beneficiaries. The average spend per beneficiary was $17,300.53.
Read our methodology - how this data is sourced, computed, and verified.