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September 2023 Formulary Changes to the Top Medicare Drugs

Monthly Formulary changes · published Sep 22, 2023

The September 2023 Medicare Part D formulary updates included 69 new drug codes or NDCs representing 41 different medications.

The NDC uniquely identifies a particular manufacturer, drug-strength, and packaging combination. The NDC is often shown on your prescription bottle as an 11-digit code (see the charts below) or could be formatted as 00000-0000-00 where the first set of numbers identifies the manufacturer, the second set of number identifies the drug and strength, and the third set of numbers identifies the packaging.

This article highlights the change for some of the "top Medicare drugs", including their generic equivalents.  The generics included are Atorvastatin [Lipitor®] , Clopidogrel [Plavix®], Escitalopram [Lexapro®], Esomeprazole Sodium [Nexium®], Pioglitazone [Actos®], Quetiapine Fumarate [Seroquel®], Risedronate Sodium [Actonel®], and Valsartan-HCTZ [Diovan HCT®].  The changes to the number of formularies covering these medications looks as follows:

Count of Formularies Covering the Top Medicare Drugs Program-wide
Formulary Count*
Drug Name 2017 End** 2018 End** 2019 End** 2020 End** 2021 End** 2022 End** 2023
Start**
September
ACTONEL 35 MG TABLET 11 13 8 11 3 3 2 2
ACTOS 30 MG TABLET 16 16 16 15 13 5 3 3
ADVAIR DISKUS MIS 250/50 371 370 361 312 289 349 314 316
ATORVASTATIN 10 MG TABLET [Lipitor] 389 394 406 454 456 458 452 450
CLOPIDOGREL 75 MG TABLET [Plavix] 389 394 406 454 456 458 452 450
DIOVAN HCT 160/12.5MG TABLET 21 54 17 18 13 5 3 3
ESCITALOPRAM 10 MG TABLET [Lexapro] 389 394 406 454 456 458 452 450
ESOMEPRAZOLE MAG DR 40 MG CAPSULE [Nexium] 305 315 309 353 376 419 416 414
LANTUS 100U/ML VIAL 382 309 306 364 363 362 393 392
LEXAPRO 10MG TABLET 12 21 14 12 13 5 4 4
LIPITOR 10MG TABLET 20 21 19 16 11 3 3 3
NEXIUM DR 40 MG CAPSULE 33 19 19 10 11 3 3 3
PIOGLITAZONE HCL 30 MG TABLET [Actos] 389 394 406 454 456 458 452 450
PLAVIX 75 MG TABLET 13 16 75 10 11 3 3 3
QUETIAPINE FUMARATE 25 MG TABLET [Seroquel] 389 394 406 454 456 458 452 450
RISEDRONATE SODIUM 35 MG TABLET [Actonel] 239 249 287 335 360 368 351 355
SEROQUEL 25MG TABLET 12 14 9 10 11 3 3 3
VALSARTAN-HCTZ 160-12.5 MG TABLET [Diovan HCT] 382 391 403 451 451 454 450 448
*The number of formularies counts the unique formularies that offer this medication. As a note, the same formulary can be used by one or many different Medicare Part D plans. The same formulary can be used by both stand-alone prescription drug plans (PDP) and Medicare Advantage plans (MAPD).

**The ending CMS formulary datasets are the respective September dataset. The starting 2023 CMS formulary dataset is dated October, 2022.

Learn more in our article: How a mid-year formulary change can affect your Medicare Part D drug coverage.

You can review any Medicare plan formulary using the on this site FormularyBrowser at FormularyBrowser.com or compare how any medication is covered on all Medicare plans in your service area using our on this site.