tafluprost 0.015 MG/ML Ophthalmic Solution [Zioptan]
tafluprost
RxCUI: 1244616
What the CMS Formulary Data Shows for tafluprost 0.015 MG/ML Ophthalmic Solution [Zioptan]
Per the CMS 2026 Part D formulary file, tafluprost 0.015 MG/ML Ophthalmic Solution [Zioptan] (RxNorm concept RXCUI 1244616, generic name tafluprost) appears on 2 distinct formulary files spanning 15 Medicare Part D plan offerings - 0.3% of enrollable Part D products, selective placement; verify formulary inclusion before enrolling. Tier placement ranges from Tier 4 to Tier 4, with a cross-plan average of Tier 4.
Real-world access to tafluprost 0.015 MG/ML Ophthalmic Solution [Zioptan] 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 15,313 Part D beneficiaries filled tafluprost 0.015 MG/ML Ophthalmic Solution [Zioptan] in 2023, with total plan-and-beneficiary spending of $12,670,015 and an average per-beneficiary annual cost of $827.40. The plan-by-plan detail below lists exactly which PDP and MA-PD contracts carry tafluprost 0.015 MG/ML Ophthalmic Solution [Zioptan] today.
Coverage Details
- Formularies covering
- 2
- Plans covering
- 15
- Coverage rate
- 0.3%
- Tier range
- Tier 4, Non-Preferred
- Average tier
- Tier 4, Non-Preferred
Restrictions
- Prior authorization required
- 0% of formularies
- Step therapy required
- 0% of formularies
- Quantity limits
- 0% of formularies
2023 Medicare Spending
- Beneficiaries
- 15,313
- Total spending
- $12,670,015
- Avg per beneficiary
- $827.40
Tier Distribution Across Plans
Medicare Advantage Plans (MA-PD) Covering tafluprost 0.015 MG/ML Ophthalmic Solution [Zioptan]
15 Medicare Advantage plans with Part D drug coverage include this drug.
| Plan | Insurer | Tier | PA | Premium | States |
|---|---|---|---|---|---|
| Personal Choice 65 Achieve Rx (PPO) | QCC INSURANCE COMPANY | T4 | No | $0 | PA |
| Keystone 65 Focus Rx (HMO-POS) | KEYSTONE HEALTH PLAN EAST, INC. | T4 | No | $0 | PA |
| Keystone 65 Focus Rx (HMO-POS) | KEYSTONE HEALTH PLAN EAST, INC. | T4 | No | $0 | PA |
| Keystone 65 Basic Rx (HMO) | KEYSTONE HEALTH PLAN EAST, INC. | T4 | No | $0 | PA |
| AmeriHealth Medicare Core (PPO) | AMERIHEALTH INSURANCE COMPANY OF NEW JERSEY | T4 | No | $0 | NJ |
| AmeriHealth Medicare Ultimate (PPO) | AMERIHEALTH INSURANCE COMPANY OF NEW JERSEY | T4 | No | $0 | NJ |
| Keystone 65 Essential Rx (HMO-POS) | KEYSTONE HEALTH PLAN EAST, INC. | T4 | No | $31.00 | PA |
| AmeriHealth Medicare Enhanced (PPO) | AMERIHEALTH INSURANCE COMPANY OF NEW JERSEY | T4 | No | $36.00 | NJ |
| Keystone 65 Select Rx (HMO) | KEYSTONE HEALTH PLAN EAST, INC. | T4 | No | $47.00 | PA |
| Keystone 65 Preferred Rx (HMO) | KEYSTONE HEALTH PLAN EAST, INC. | T4 | No | $59.70 | PA |
| Keystone 65 Select Rx (HMO) | KEYSTONE HEALTH PLAN EAST, INC. | T4 | No | $63.50 | PA |
| Keystone 65 Preferred Rx (HMO) | KEYSTONE HEALTH PLAN EAST, INC. | T4 | No | $79.70 | PA |
| Personal Choice 65 Plus Rx (PPO) | QCC INSURANCE COMPANY | T4 | No | $81.20 | PA |
| Personal Choice 65 Rx (PPO) | QCC INSURANCE COMPANY | T4 | No | $102.20 | PA |
| Personal Choice 65 Rx (PPO) | QCC INSURANCE COMPANY | T4 | No | $112.70 | PA |
Frequently Asked Questions
Is tafluprost 0.015 MG/ML Ophthalmic Solution [Zioptan] covered by Medicare Part D?
Yes, tafluprost 0.015 MG/ML Ophthalmic Solution [Zioptan] is covered by 15 Medicare Part D plans (0.3% of all Part D formularies).
What tier is tafluprost 0.015 MG/ML Ophthalmic Solution [Zioptan] on Medicare Part D plans?
tafluprost 0.015 MG/ML Ophthalmic Solution [Zioptan] averages Tier 4 across Part D plans, ranging from Tier 4 to Tier 4.
Does tafluprost 0.015 MG/ML Ophthalmic Solution [Zioptan] require prior authorization?
0% of Part D formularies require prior authorization for tafluprost 0.015 MG/ML Ophthalmic Solution [Zioptan]. Step therapy: 0%. Quantity limits: 0%.
How much does Medicare spend on tafluprost 0.015 MG/ML Ophthalmic Solution [Zioptan]?
In 2023, total Medicare Part D spending on tafluprost 0.015 MG/ML Ophthalmic Solution [Zioptan] was $12,670,015, covering 15,313 beneficiaries. The average spend per beneficiary was $827.40.
Read our methodology - how this data is sourced, computed, and verified.