Medicare Part D coverage · varenicline · RxCUI 2572371
varenicline 0.03 MG/ACTUAT Nasal Spray [Tyrvaya]
Per the CMS 2026 Part D formulary file, varenicline 0.03 MG/ACTUAT Nasal Spray [Tyrvaya] is covered by 972 Medicare Part D plans (19.2% of enrollable products), averaging Tier 3.6, with prior authorization required on 2.6% of covering formularies.
- 19.2%
- Plan coverage
- 972
- Plans covering
- T3.6
- Avg tier
- 2.6%
- Prior auth required
What the CMS Formulary Data Shows for varenicline 0.03 MG/ACTUAT Nasal Spray [Tyrvaya]
Per the CMS 2026 Part D formulary file, varenicline 0.03 MG/ACTUAT Nasal Spray [Tyrvaya] (RxNorm concept RXCUI 2572371, generic name varenicline) appears on 38 distinct formulary files spanning 972 Medicare Part D plan offerings - 19.2% 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 3.6.
Real-world access to varenicline 0.03 MG/ACTUAT Nasal Spray [Tyrvaya] depends on utilization management as much as tier placement: 2.6% of covering formularies require prior authorization. 7.9% require step therapy. 81.6% apply quantity limits.
Historical spending context from the CMS Medicare Part D Drug Spending Dashboard shows 197,586 Part D beneficiaries filled varenicline 0.03 MG/ACTUAT Nasal Spray [Tyrvaya] 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 0.03 MG/ACTUAT Nasal Spray [Tyrvaya] today.
Coverage Details
- Formularies covering
- 38
- Plans covering
- 972
- Coverage rate
- 19.2%
- Tier range
- Tier 1 – Tier 4
- Average tier
- Tier 4, Non-Preferred
Restrictions
- Prior authorization required
- 2.6% of formularies
- Step therapy required
- 7.9% of formularies
- Quantity limits
- 81.6% of formularies
2023 Medicare Spending
- Beneficiaries
- 197,586
- Total spending
- $189,563,599
- Avg per beneficiary
- $959.40
Tier Distribution Across Plans
Standalone Drug Plans (PDP) Covering varenicline 0.03 MG/ACTUAT Nasal Spray [Tyrvaya]
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 | T4 | No | No | $0 | - |
| AARP Medicare Rx Preferred from UHC (PDP) | Unitedhealthcare INS. Co. & UHC INS. Co. OF NY | T4 | No | No | $0 | - |
Medicare Advantage Plans (MA-PD) Covering varenicline 0.03 MG/ACTUAT Nasal Spray [Tyrvaya]
98 Medicare Advantage plans with Part D drug coverage include this drug.
| Plan | Insurer | Tier | PA | Premium | States |
|---|---|---|---|---|---|
| Provider Partners Pennsylvania Community Plan (HMO I-SNP) | Provider Partners Health Plan OF Pennsylvania, Inc | T1 | No | $0 | PA |
| Provider Partners North Carolina Community Plan (HMO I-SNP) | Provider Partners Health Plan OF North Carolina | T1 | No | $0 | NC |
| Provider Partners Indiana Community Plan (HMO I-SNP) | Provider Partners Health Plan OF Indiana | T1 | No | $0 | IN |
| Provider Partners Missouri Community Plan (HMO I-SNP) | Provider Partners Health Plan OF Missouri, Inc. | T1 | No | $0 | MO |
| Mass General Brigham SCO (HMO D-SNP) | Mass General Brigham Health Plan, Inc | T1 | No | $0 | MA |
| Mass General Brigham One Care (HMO D-SNP) | Mass General Brigham Health Plan, Inc | T1 | No | $0 | MA |
| Tufts Health One Care (HMO D-SNP) | Tufts Health Public Plans, Inc. | T1 | No | $0 | MA |
| Tufts Health One Care CW (HMO D-SNP) | Tufts Health Public Plans, Inc. | T1 | No | $0 | MA |
| Tufts Health Plan Senior Care Options (HMO D-SNP) | Tufts Associated Health Maintenance Organization | T1 | No | $0 | MA |
| Tufts Health Plan Senior Care Options CW (HMO D-SNP) | Tufts Associated Health Maintenance Organization | T1 | No | $0 | MA |
| Provider Partners Texas Advantage Plan (HMO I-SNP) | Provider Partners Health Plan OF Texas, Inc. | T1 | No | $4.80 | TX |
| Provider Partners Illinois Advantage Plan (HMO I-SNP) | Provider Partners Health Plan OF Illinois | T1 | No | $15.20 | IL |
| Provider Partners Pennsylvania Advantage Plan (HMO I-SNP) | Provider Partners Health Plan OF Pennsylvania, Inc | T1 | No | $32.70 | PA |
| Provider Partners Pennsylvania Essential Plan (HMO I-SNP) | Provider Partners Health Plan OF Pennsylvania, Inc | T1 | No | $32.70 | PA |
| Provider Partners North Carolina Advantage Plan (HMO I-SNP) | Provider Partners Health Plan OF North Carolina | T1 | No | $36.20 | NC |
| Provider Partners North Carolina Essential Plan (HMO I-SNP) | Provider Partners Health Plan OF North Carolina | T1 | No | $36.20 | NC |
| Provider Partners Indiana Advantage Plan (HMO I-SNP) | Provider Partners Health Plan OF Indiana | T1 | No | $38.40 | IN |
| Provider Partners Indiana Essential Plan (HMO I-SNP) | Provider Partners Health Plan OF Indiana | T1 | No | $38.40 | IN |
| Provider Partners Kentucky Advantage Plan (HMO I-SNP) | Provider Partners Health Plan OF Kentucky | T1 | No | $38.40 | KY |
| Provider Partners Missouri Advantage Plan (HMO I-SNP) | Provider Partners Health Plan OF Missouri, Inc. | T1 | No | $43.00 | MO |
Show the next 30 plans
| Provider Partners Missouri Essential Plan (HMO I-SNP) | Provider Partners Health Plan OF Missouri, Inc. | T1 | No | $43.00 | MO |
| CalOptima Health OneCare Complete (HMO D-SNP) | Orange County Health Authority | T2 | Yes | $0 | CA |
| Select Health Medicare Essential (HMO) | Selecthealth, Inc. | T3 | No | $0 | UT |
| Select Health Medicare Essential (HMO) | Selecthealth, Inc. | T3 | No | $0 | NV |
| Select Health Medicare Dual (HMO D-SNP) | Selecthealth, Inc. | T3 | No | $0 | UT |
| Select Health Medicare Essential (HMO) | Selecthealth, Inc. | T3 | No | $0 | UT |
| Select Health Medicare + Kroger (HMO) | Selecthealth, Inc. | T3 | No | $0 | NV |
| Select Health Medicare + Kroger (HMO) | Selecthealth, Inc. | T3 | No | $0 | UT |
| Select Health Medicare Essential (HMO) | Selecthealth, Inc. | T3 | No | $0 | CO |
| Select Health Medicare Essential (HMO) | Selecthealth, Inc. | T3 | No | $0 | CO |
| Select Health Medicare + Kroger (HMO) | Selecthealth, Inc. | T3 | No | $0 | CO |
| Select Health Medicare Flex (HMO) | Selecthealth, Inc. | T3 | No | $0 | CO |
| Select Health Medicare + Kroger (HMO) | Selecthealth, Inc. | T3 | No | $0 | CO |
| Select Health Medicare Active (HMO) | Selecthealth, Inc. | T3 | No | $0 | CO |
| Select Health Medicare Dual (HMO D-SNP) | Selecthealth, Inc. | T3 | No | $0 | NV |
| Select Health Medicare Wellness (HMO) | Selecthealth, Inc. | T3 | No | $0 | NV |
| Healthy Mississippi Premier Advantage (HMO-POS) | Healthy Mississippi, Inc. | T3 | No | $0 | MS |
| UHC Dual Complete IA-S001 (HMO-POS D-SNP) | Unitedhealthcare OF Wisconsin, Inc. | T4 | No | $0 | IA |
| UHC Dual Complete MO-S001 (HMO-POS D-SNP) | Unitedhealthcare OF Wisconsin, Inc. | T4 | No | $0 | MO |
| UHC Dual Complete NE-S001 (HMO-POS D-SNP) | Unitedhealthcare OF Wisconsin, Inc. | T4 | No | $0 | NE |
| UHC Dual Complete KS-S001 (HMO-POS D-SNP) | Unitedhealthcare OF Wisconsin, Inc. | T4 | No | $0 | KS |
| UHC Dual Complete MO-S3 (HMO-POS D-SNP) | Unitedhealthcare OF Wisconsin, Inc. | T4 | No | $0 | MO |
| UHC Dual Complete KS-Q1 (HMO-POS D-SNP) | Unitedhealthcare OF Wisconsin, Inc. | T4 | No | $0 | KS |
| UHC Dual Complete TN-S001 (HMO-POS D-SNP) | Unitedhealthcare Plan OF THE River Valley, Inc. | T4 | No | $0 | TN |
| UHC Dual Complete TN-Y001 (HMO-POS D-SNP) | Unitedhealthcare Plan OF THE River Valley, Inc. | T4 | No | $0 | TN |
| UHC Dual Complete TN-Y2 (HMO-POS D-SNP) | Unitedhealthcare Plan OF THE River Valley, Inc. | T4 | No | $0 | TN |
| AARP Medicare Advantage from UHC MI-0001 (PPO) | Unitedhealthcare Insurance Company | T4 | No | $0 | MI |
| UHC Dual Complete NM-Y1 (PPO D-SNP) | Unitedhealthcare Insurance Company | T4 | No | $0 | NM |
| UHC Dual Complete NM-S1 (PPO D-SNP) | Unitedhealthcare Insurance Company | T4 | No | $0 | NM |
| UHC Dual Complete NM-V1 (PPO D-SNP) | Unitedhealthcare Insurance Company | T4 | No | $0 | NM |
Showing top 50 of 98 plans.
Frequently Asked Questions
Is varenicline 0.03 MG/ACTUAT Nasal Spray [Tyrvaya] covered by Medicare Part D?
Yes, varenicline 0.03 MG/ACTUAT Nasal Spray [Tyrvaya] is covered by 972 Medicare Part D plans (19.2% of all Part D formularies).
What tier is varenicline 0.03 MG/ACTUAT Nasal Spray [Tyrvaya] on Medicare Part D plans?
varenicline 0.03 MG/ACTUAT Nasal Spray [Tyrvaya] averages Tier 3.6 across Part D plans, ranging from Tier 1 to Tier 4.
Does varenicline 0.03 MG/ACTUAT Nasal Spray [Tyrvaya] require prior authorization?
2.6% of Part D formularies require prior authorization for varenicline 0.03 MG/ACTUAT Nasal Spray [Tyrvaya]. Step therapy: 7.9%. Quantity limits: 81.6%.
How much does Medicare spend on varenicline 0.03 MG/ACTUAT Nasal Spray [Tyrvaya]?
In 2023, total Medicare Part D spending on varenicline 0.03 MG/ACTUAT Nasal Spray [Tyrvaya] 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.
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
Similar prior-authorization rate
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- ceftaroline fosamil 600 MG Injection 2.7% PA
- entecavir 0.05 MG/ML Oral Solution [Baraclude] 2.7% PA
- pentosan polysulfate 100 MG Oral Capsule [Elmiron] 2.7% PA