sulfamethoxazole 800 MG / trimethoprim 160 MG Oral Tablet
sulfamethoxazole
RxCUI: 198335
What the CMS Formulary Data Shows for sulfamethoxazole 800 MG / trimethoprim 160 MG Oral Tablet
Per the CMS 2026 Part D formulary file, sulfamethoxazole 800 MG / trimethoprim 160 MG Oral Tablet (RxNorm concept RXCUI 198335, generic name sulfamethoxazole) 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 2, with a cross-plan average of Tier 1.2.
Real-world access to sulfamethoxazole 800 MG / trimethoprim 160 MG Oral Tablet depends on utilization management as much as tier placement: 0% 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 3,086,523 Part D beneficiaries filled sulfamethoxazole 800 MG / trimethoprim 160 MG Oral Tablet in 2023, with total plan-and-beneficiary spending of $28,506,828 and an average per-beneficiary annual cost of $9.24. The plan-by-plan detail below lists exactly which PDP and MA-PD contracts carry sulfamethoxazole 800 MG / trimethoprim 160 MG Oral Tablet today.
Coverage Details
- Formularies covering
- 330
- Plans covering
- 5,067
- Coverage rate
- 100%
- Tier range
- Tier 1 – Tier 2
- Average tier
- Tier 1, Preferred Generic
Restrictions
- Prior authorization required
- 0% of formularies
- Step therapy required
- 0% of formularies
- Quantity limits
- 0% of formularies
2023 Medicare Spending
- Beneficiaries
- 3,086,523
- Total spending
- $28,506,828
- Avg per beneficiary
- $9.24
Tier Distribution Across Plans
Standalone Drug Plans (PDP) Covering sulfamethoxazole 800 MG / trimethoprim 160 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 sulfamethoxazole 800 MG / trimethoprim 160 MG Oral Tablet
98 Medicare Advantage plans with Part D drug coverage include this drug.
Frequently Asked Questions
Is sulfamethoxazole 800 MG / trimethoprim 160 MG Oral Tablet covered by Medicare Part D?
Yes, sulfamethoxazole 800 MG / trimethoprim 160 MG Oral Tablet is covered by 5,067 Medicare Part D plans (100% of all Part D formularies).
What tier is sulfamethoxazole 800 MG / trimethoprim 160 MG Oral Tablet on Medicare Part D plans?
sulfamethoxazole 800 MG / trimethoprim 160 MG Oral Tablet averages Tier 1.2 across Part D plans, ranging from Tier 1 to Tier 2.
Does sulfamethoxazole 800 MG / trimethoprim 160 MG Oral Tablet require prior authorization?
0% of Part D formularies require prior authorization for sulfamethoxazole 800 MG / trimethoprim 160 MG Oral Tablet. Step therapy: 0%. Quantity limits: 0%.
How much does Medicare spend on sulfamethoxazole 800 MG / trimethoprim 160 MG Oral Tablet?
In 2023, total Medicare Part D spending on sulfamethoxazole 800 MG / trimethoprim 160 MG Oral Tablet was $28,506,828, covering 3,086,523 beneficiaries. The average spend per beneficiary was $9.24.
Read our methodology - how this data is sourced, computed, and verified.