varenicline 0.5 MG Oral Tablet [Chantix]
varenicline
RxCUI: 637188
What the CMS Formulary Data Shows for varenicline 0.5 MG Oral Tablet [Chantix]
Per the CMS 2026 Part D formulary file, varenicline 0.5 MG Oral Tablet [Chantix] (RxNorm concept RXCUI 637188, generic name varenicline) appears on 1 distinct formulary file spanning 4 Medicare Part D plan offerings - 0.1% 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 varenicline 0.5 MG Oral Tablet [Chantix] depends on utilization management as much as tier placement: 0% of covering formularies require prior authorization. 0% require step therapy. 100% apply quantity limits.
Historical spending context from the CMS Medicare Part D Drug Spending Dashboard shows 197,586 Part D beneficiaries filled varenicline 0.5 MG Oral Tablet [Chantix] in 2023, with total plan-and-beneficiary spending of $189,563,599 and an average per-beneficiary annual cost of $959.40. The plan-by-plan detail below lists exactly which PDP and MA-PD contracts carry varenicline 0.5 MG Oral Tablet [Chantix] today.
Coverage Details
- Formularies covering
- 1
- Plans covering
- 4
- Coverage rate
- 0.1%
- 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
- 100% of formularies
2023 Medicare Spending
- Beneficiaries
- 197,586
- Total spending
- $189,563,599
- Avg per beneficiary
- $959.40
Tier Distribution Across Plans
Medicare Advantage Plans (MA-PD) Covering varenicline 0.5 MG Oral Tablet [Chantix]
4 Medicare Advantage plans with Part D drug coverage include this drug.
| Plan | Insurer | Tier | PA | Premium | States |
|---|---|---|---|---|---|
| Health New England Medicare Compass (PPO) | HEALTH NEW ENGLAND, INC. | T4 | No | $0 | MA |
| Health New England Medicare Value (HMO) | HEALTH NEW ENGLAND, INC. | T4 | No | $0 | MA |
| Health New England Medicare Premium (HMO) | HEALTH NEW ENGLAND, INC. | T4 | No | $15.80 | MA |
| Health New England Medicare Plus (HMO) | HEALTH NEW ENGLAND, INC. | T4 | No | $58.40 | MA |
Frequently Asked Questions
Is varenicline 0.5 MG Oral Tablet [Chantix] covered by Medicare Part D?
Yes, varenicline 0.5 MG Oral Tablet [Chantix] is covered by 4 Medicare Part D plans (0.1% of all Part D formularies).
What tier is varenicline 0.5 MG Oral Tablet [Chantix] on Medicare Part D plans?
varenicline 0.5 MG Oral Tablet [Chantix] averages Tier 4 across Part D plans, ranging from Tier 4 to Tier 4.
Does varenicline 0.5 MG Oral Tablet [Chantix] require prior authorization?
0% of Part D formularies require prior authorization for varenicline 0.5 MG Oral Tablet [Chantix]. Step therapy: 0%. Quantity limits: 100%.
How much does Medicare spend on varenicline 0.5 MG Oral Tablet [Chantix]?
In 2023, total Medicare Part D spending on varenicline 0.5 MG Oral Tablet [Chantix] was $189,563,599, covering 197,586 beneficiaries. The average spend per beneficiary was $959.40.
Read our methodology - how this data is sourced, computed, and verified.