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April 2024 Formulary Changes to the Top Medicare Drugs

Category: Monthly Formulary changes
Published: Apr, 29 2024 08:04:43

The April 2024 Medicare Part D formulary updates included 67 new drug codes or NDCs representing 47 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®], FLUTICASONE-SALMETEROL [Advair®], 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 2018 End** 2019 End** 2020 End** 2021 End** 2022 End** 2023 End** 2024
ACTONEL 35 MG TABLET 13 8 11 3 3 2 1 1
ACTOS 30 MG TABLET 16 16 15 13 5 3 4 4
ADVAIR DISKUS MIS 250/50 370 361 312 289 349 316 18 15
ATORVASTATIN 10 MG TABLET [Lipitor] 394 406 454 456 458 450 423 421
CLOPIDOGREL 75 MG TABLET [Plavix] 394 406 454 456 458 450 423 421
DIOVAN HCT 160/12.5MG TABLET 54 17 18 13 5 3 4 4
ESCITALOPRAM 10 MG TABLET [Lexapro] 394 406 454 456 458 450 423 421
ESOMEPRAZOLE MAG DR 40 MG CAPSULE [Nexium] 315 309 353 376 419 414 391 389
396 398
LANTUS 100U/ML VIAL 309 306 364 363 362 392 350 352
LEXAPRO 10MG TABLET 21 14 12 13 5 4 4 4
LIPITOR 10MG TABLET 21 19 16 11 3 3 4 4
NEXIUM DR 40 MG CAPSULE 19 19 10 11 3 3 4 4
PIOGLITAZONE HCL 30 MG TABLET [Actos] 394 406 454 456 458 450 423 421
PLAVIX 75 MG TABLET 16 75 10 11 3 3 4 4
QUETIAPINE FUMARATE 25 MG TABLET [Seroquel] 394 406 454 456 458 450 423 421
RISEDRONATE SODIUM 35 MG TABLET [Actonel] 249 287 335 360 368 355 338 339
SEROQUEL 25MG TABLET 14 9 10 11 3 3 4 4
VALSARTAN-HCTZ 160-12.5 MG TABLET [Diovan HCT] 391 403 451 451 454 448 422 420

*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 2024 CMS formulary dataset is dated October, 2023.

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 Q1Medicare.com FormularyBrowser at FormularyBrowser.com or compare how any medication is covered on all Medicare plans in your service area using our Q1Rx.com.

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