Medicare Part D coverage · tirbanibulin · RxCUI 2471100
tirbanibulin 0.01 MG/MG Topical Ointment [Klisyri]
Per the CMS 2026 Part D formulary file, tirbanibulin 0.01 MG/MG Topical Ointment [Klisyri] is covered by 501 Medicare Part D plans (9.9% of enrollable products), averaging Tier 4, with prior authorization required on 12.3% of covering formularies.
- 9.9%
- Plan coverage
- 501
- Plans covering
- T4
- Avg tier
- 12.3%
- Prior auth required
What the CMS Formulary Data Shows for tirbanibulin 0.01 MG/MG Topical Ointment [Klisyri]
Per the CMS 2026 Part D formulary file, tirbanibulin 0.01 MG/MG Topical Ointment [Klisyri] (RxNorm concept RXCUI 2471100, generic name tirbanibulin) appears on 65 distinct formulary files spanning 501 Medicare Part D plan offerings - 9.9% of enrollable Part D products, selective placement; verify formulary inclusion before enrolling. Tier placement ranges from Tier 1 to Tier 5, with a cross-plan average of Tier 4.
Real-world access to tirbanibulin 0.01 MG/MG Topical Ointment [Klisyri] depends on utilization management as much as tier placement: 12.3% of covering formularies require prior authorization. 83.1% require step therapy. 84.6% apply quantity limits.
Historical spending context from the CMS Medicare Part D Drug Spending Dashboard shows 1,900 Part D beneficiaries filled tirbanibulin 0.01 MG/MG Topical Ointment [Klisyri] in 2023, with total plan-and-beneficiary spending of $3,001,296 and an average per-beneficiary annual cost of $1,579.63. The plan-by-plan detail below lists exactly which PDP and MA-PD contracts carry tirbanibulin 0.01 MG/MG Topical Ointment [Klisyri] today.
Coverage Details
- Formularies covering
- 65
- Plans covering
- 501
- Coverage rate
- 9.9%
- Tier range
- Tier 1 – Tier 5
- Average tier
- Tier 4, Non-Preferred
Restrictions
- Prior authorization required
- 12.3% of formularies
- Step therapy required
- 83.1% of formularies
- Quantity limits
- 84.6% of formularies
2023 Medicare Spending
- Beneficiaries
- 1,900
- Total spending
- $3,001,296
- Avg per beneficiary
- $1,579.63
Tier Distribution Across Plans
Standalone Drug Plans (PDP) Covering tirbanibulin 0.01 MG/MG Topical Ointment [Klisyri]
9 standalone prescription drug plans include this drug.
| Plan | Insurer | Tier | PA | ST | Premium | States |
|---|---|---|---|---|---|---|
| HealthSpring Assurance Rx (PDP) | Medco Containment Life AND Medco Containment NY | T4 | No | Yes | $0 | - |
| HealthSpring Assurance Rx (PDP) | Medco Containment Life AND Medco Containment NY | T4 | No | Yes | $0 | - |
| HealthSpring Assurance Rx (PDP) | Medco Containment Life AND Medco Containment NY | T4 | No | Yes | $0 | - |
| HealthSpring Assurance Rx (PDP) | Medco Containment Life AND Medco Containment NY | T4 | No | Yes | $0 | - |
| HealthSpring Assurance Rx (PDP) | Medco Containment Life AND Medco Containment NY | T4 | No | Yes | $0 | - |
| HealthSpring Assurance Rx (PDP) | Medco Containment Life AND Medco Containment NY | T4 | No | Yes | $0 | - |
| HealthSpring Assurance Rx (PDP) | Medco Containment Life AND Medco Containment NY | T4 | No | Yes | $0 | - |
| HealthSpring Assurance Rx (PDP) | Medco Containment Life AND Medco Containment NY | T4 | No | Yes | $0 | - |
| HealthSpring Assurance Rx (PDP) | Medco Containment Life AND Medco Containment NY | T4 | No | Yes | $0 | - |
Medicare Advantage Plans (MA-PD) Covering tirbanibulin 0.01 MG/MG Topical Ointment [Klisyri]
91 Medicare Advantage plans with Part D drug coverage include this drug.
| Plan | Insurer | Tier | PA | Premium | States |
|---|---|---|---|---|---|
| Elevate Medicare Choice (HMO D-SNP) | Denver Health Medical Plan, Inc. | T1 | No | $0 | CO |
| AllCare Advantage Redwood Rx (HMO D-SNP) | Allcare Health Plan, Inc. | T1 | No | $0 | OR |
| PrimeWest Senior Health Complete (HMO D-SNP) | Primewest Rural MN Health Care Access Initiative | T1 | No | $0 | MN |
| Prime Health Complete (HMO D-SNP) | Primewest Rural MN Health Care Access Initiative | T1 | No | $0 | MN |
| Alterwood Advantage Dual Secure (HMO D-SNP) | Alterwood Advantage, Inc. | T1 | No | $0 | MD |
| Nascentia Dual Advantage (HMO D-SNP) | Visiting Nurse Association OF Central NEW York | T1 | No | $0 | NY |
| Abilis Health Community (HMO I-SNP) | Signature Advantage, LLC | T1 | No | $0 | KY, TN |
| Arkansas Integrated Providers (AIP) Dual Advantage (HMO D-SNP) | Arkansas Superior Select, Inc. | T1 | No | $0 | AR |
| 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 |
| Gold Dialysis & Kidney Complete (HMO-POS C-SNP) | Gold Kidney OF Florida Inc | T1 | No | $4.80 | FL |
| Texas Independence Health Plan, Inc. (HMO I-SNP) | Texas Independence Health Plan, Inc. | T1 | No | $4.80 | TX |
| Texas Independence Community Plan (HMO I-SNP) | Texas Independence Health Plan, Inc. | T1 | No | $4.80 | TX |
| Tribute Select (HMO-POS I-SNP) | Arkansas Superior Select, Inc. | T1 | No | $8.90 | AR |
| ATRIO Special Needs Plan (HMO D-SNP) | Atrio Health Plans | T1 | No | $10.50 | OR |
| ATRIO Special Needs Plan (HMO D-SNP) | Atrio Health Plans | T1 | No | $10.50 | OR |
| Gold Dialysis & Kidney Complete (HMO-POS C-SNP) | Gold Kidney OF Arizona | T1 | No | $17.00 | AZ |
| Alterwood Advantage Dual Value (HMO D-SNP) | Alterwood Advantage, Inc. | T1 | No | $31.20 | MD |
| Valor Health Plan (HMO I-SNP) | TSG Guard, Inc. | T1 | No | $31.40 | OH |
| WV Senior Advantage (HMO I-SNP) | West Virginia Senior Advantage, Inc. | T1 | No | $32.70 | WV |
Show the next 30 plans
| Abilis Health (HMO I-SNP) | Signature Advantage, LLC | T1 | No | $35.90 | KY, TN |
| CommuniCare Advantage ISNP (HMO I-SNP) | OH CHS SNP Inc. | T1 | No | $38.40 | IN, MD, OH |
| Nascentia Skilled Nursing Facility (HMO I-SNP) | Visiting Nurse Association OF Central NEW York | T1 | No | $58.80 | NY |
| HealthSpring Preferred (HMO) | Bravo Health Pennsylvania, Inc. | T4 | No | $0 | AZ |
| HealthSpring Alliance (HMO) | Bravo Health Pennsylvania, Inc. | T4 | No | $0 | AZ |
| HealthSpring Preferred Savings (HMO) | Bravo Health Pennsylvania, Inc. | T4 | No | $0 | AZ |
| HealthSpring Preferred Full Savings (HMO) | Bravo Health Pennsylvania, Inc. | T4 | No | $0 | AZ |
| HealthSpring Preferred GA (HMO) | Healthspring Life & Health Insurance Company, Inc. | T4 | No | $0 | GA |
| HealthSpring Preferred (HMO) | Healthspring Life & Health Insurance Company, Inc. | T4 | No | $0 | GA |
| HealthSpring Preferred (HMO) | Healthspring Life & Health Insurance Company, Inc. | T4 | No | $0 | GA |
| HealthSpring Preferred (HMO) | Healthspring Life & Health Insurance Company, Inc. | T4 | No | $0 | GA |
| HealthSpring Preferred (HMO) | Healthspring Life & Health Insurance Company, Inc. | T4 | No | $0 | GA |
| HealthSpring Preferred (HMO) | Healthspring Life & Health Insurance Company, Inc. | T4 | No | $0 | GA |
| HealthSpring Preferred (HMO) | Healthspring Life & Health Insurance Company, Inc. | T4 | No | $0 | GA |
| HealthSpring Preferred Savings (HMO) | Healthspring Life & Health Insurance Company, Inc. | T4 | No | $0 | GA |
| HealthSpring Preferred Savings (HMO) | Healthspring Life & Health Insurance Company, Inc. | T4 | No | $0 | GA |
| HealthSpring Preferred Savings (HMO) | Healthspring Life & Health Insurance Company, Inc. | T4 | No | $0 | GA |
| HealthSpring Preferred Savings (HMO) | Healthspring Life & Health Insurance Company, Inc. | T4 | No | $0 | GA |
| HealthSpring Preferred (HMO) | Healthspring Life & Health Insurance Company, Inc. | T4 | No | $0 | MO |
| HealthSpring Preferred Savings (HMO) | Healthspring Life & Health Insurance Company, Inc. | T4 | No | $0 | MO |
| HealthSpring Premier (HMO-POS) | Healthspring Life & Health Insurance Company, Inc. | T4 | No | $0 | UT |
| HealthSpring Preferred (HMO) | Healthspring Healthcare OF Colorado, Inc. | T4 | No | $0 | NM |
| HealthSpring Preferred (HMO) | Healthspring Healthcare OF Colorado, Inc. | T4 | No | $0 | OH |
| HealthSpring Preferred (HMO) | Healthspring Healthcare OF Colorado, Inc. | T4 | No | $0 | KY, OH |
| HealthSpring Preferred Savings (HMO) | Healthspring Healthcare OF Colorado, Inc. | T4 | No | $0 | OH |
| HealthSpring Preferred Savings (HMO) | Healthspring Healthcare OF Colorado, Inc. | T4 | No | $0 | KY, OH |
| HealthSpring Preferred (HMO) | Healthspring Healthcare OF Colorado, Inc. | T4 | No | $0 | CO |
| HealthSpring Preferred (HMO) | Bravo Health Mid-atlantic, Inc. | T4 | No | $0 | DC, DE |
| HealthSpring Preferred PA (HMO) | Bravo Health Pennsylvania, Inc. | T4 | No | $0 | PA |
| HealthSpring Preferred (HMO) | Bravo Health Pennsylvania, Inc. | T4 | No | $0 | PA |
Showing top 50 of 91 plans.
Frequently Asked Questions
Is tirbanibulin 0.01 MG/MG Topical Ointment [Klisyri] covered by Medicare Part D?
Yes, tirbanibulin 0.01 MG/MG Topical Ointment [Klisyri] is covered by 501 Medicare Part D plans (9.9% of all Part D formularies).
What tier is tirbanibulin 0.01 MG/MG Topical Ointment [Klisyri] on Medicare Part D plans?
tirbanibulin 0.01 MG/MG Topical Ointment [Klisyri] averages Tier 4 across Part D plans, ranging from Tier 1 to Tier 5.
Does tirbanibulin 0.01 MG/MG Topical Ointment [Klisyri] require prior authorization?
12.3% of Part D formularies require prior authorization for tirbanibulin 0.01 MG/MG Topical Ointment [Klisyri]. Step therapy: 83.1%. Quantity limits: 84.6%.
How much does Medicare spend on tirbanibulin 0.01 MG/MG Topical Ointment [Klisyri]?
In 2023, total Medicare Part D spending on tirbanibulin 0.01 MG/MG Topical Ointment [Klisyri] was $3,001,296, covering 1,900 beneficiaries. The average spend per beneficiary was $1,579.63.
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
- erlotinib 150 MG Oral Tablet T4
- linezolid 20 MG/ML Oral Suspension T4
- 1 ML ustekinumab-kfce 90 MG/ML Prefilled Syringe [Yesintek] T4
- edaravone 21 MG/ML Oral Suspension [Radicava] T4
- deutivacaftor 125 MG / tezacaftor 50 MG / vanzacaftor 10 MG Oral Tablet [Alyftrek] T4
- somatropin 8 MG/ML Injectable Solution [Serostim] T4
Similar prior-authorization rate
- {28 (estradiol 1 MG / norethindrone acetate 0.5 MG Oral Tablet) } Pack 12.3% PA
- 200 ML fluconazole 2 MG/ML Injection 12.5% PA
- 3 ML insulin glargine-aglr 100 UNT/ML Pen Injector [Rezvoglar] 12.5% PA
- 100 ML fluconazole 2 MG/ML Injection 12.5% PA
- levorphanol tartrate 2 MG Oral Tablet 12.5% PA
- caspofungin acetate 70 MG Injection 12.5% PA