A non-government resource for the Medicare community
Powered by Q1Group LLC
A non-government Medicare community resource

Eight (8) New Generic Equivalents Added to Medicare Part D formularies in July 2017

Category: Monthly Formulary Changes
Published: Jul, 17 2017 06:07:55

The July, 2017 Medicare Part D formulary data updates included a total of 8 new generic equivalents (manufacturer, drug, strength, and packaging combinations) or National Drug Codes (NDCs) representing 5 specific generic drugs.

What exactly is an NDC?
The National Drug Code (NDC) uniquely identifies a particular drug, manufacturer, 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 product and strength, and the third set of numbers identifies the packaging.

Some interesting additions to the 2017 Medicare Part D (PDP) and Medicare Advantage plan (MAPD) formularies include:

Generic Drug Equivalent [Brand-Name Drug]

Number of

Number of

Desvenlafaxine Succinate ER 100 mg [Pristiq] 54 324
Desvenlafaxine Succinate ER 25 mg [Pristiq] 57 325
Desvenlafaxine Succinate ER 50 mg [Pristiq] 54 324
Flurandrenolide 0.05% Ointment [Cordran] 8 63
Irbesartan-hctz 300-12.5 mg tb [Avalide] 53 327
Montelukast sod 4 mg tab chew [Singulair] 57 333
Montelukast sod 5 mg tab chew [Singulair] 57 333
Zoledronic acid 4 mg/5 ml vial [Zometa] 57 332

The following table details the eight (8) manufacturer / drug / strength / packaging combinations (NDCs) that were added to one or more Medicare Part D formularies in the April 2017 updates. You can click on the NDC or Drug Name below to go to our Q1Medicare.com Drug Finder to see the details of how this drug is handled by all Medicare Part D Plans in Florida (our example state). -- You can then change the state to your state for details in your service area.

July 2017 Generic Medications Added to Medicare Part D
NDC Generic Drug Name Brand-Name Drug
68180059306 Desvenlafaxine Succinate ER 100 mg [Pristiq]
00591406030 Desvenlafaxine Succinate ER 25 mg tb [Pristiq]
68180059206 Desvenlafaxine Succinate ER 50 mg tb [Pristiq]
52565001760 Flurandrenolide 0.05% Ointment [Cordran]
00054025513 Irbesartan-hctz 300-12.5 mg tb [Avalide]
65862056790 Montelukast sod 4 mg tab chew [Singulair]
65862056890 Montelukast sod 5 mg tab chew [Singulair]
00143964201 Zoledronic acid 4 mg/5 ml vial [Zometa]

What Could the Addition of New Generic Drugs Mean to You?

  • You may be able to save money by switching from the brand-name drug to its generic equivalent – with your prescriber’s approval and a new prescription.  Please note, you will need to look carefully at coverage costs as we have found that many 2017 generics are being offered on the same tier as their brand-name equivalent or the generics do not have a significantly lower retail price.  For example, the brand-name Tamiflu (45 mg) may have a retail cost of around $132.16 as a Tier 4 drug (35% co-insurance) and the same plan may now cover the generic equivalent OSELTAMIVIR PHOS 45 MG also as a Tier 4 drug (35% co-insurance).  You can click here to see how your Medicare drug plan is covering these medication.

  • Your brand-name drug may no longer be available if a generic is now available.  From past experience, we may find that many Medicare Part D plans discontinue coverage of a brand-name drug in the months following the introduction of a generic equivalent.  If you have received notice from your Medicare Part D plan that your brand-name medication will be dropped, you should speak with your prescriber to determine if you can take the generic equivalent or if you will need to ask your plan for a formulary exception to continue coverage for the brand-name drug.  You can click for a chart showing the trends in formulary coverage for some of the most popular Medicare drugs and their generic equivalents.
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.

Tips & Disclaimers
  • Q1Medicare®, Q1Rx®, and Q1Group® are registered Service Marks of Q1Group LLC and may not be used in any advertising, publicity, or for commercial purposes without the express authorization of Q1Group.
  • The Medicare Advantage and Medicare Part D prescription drug plan data on our site comes directly from Medicare and is subject to change.
  • Medicare has neither reviewed nor endorsed the information on our site.
  • We provide our Q1Medicare.com site for educational purposes and strive to present unbiased and accurate information. However, Q1Medicare is not intended as a substitute for your lawyer, doctor, healthcare provider, financial advisor, or pharmacist. For more information on your Medicare coverage, please be sure to seek legal, medical, pharmaceutical, or financial advice from a licensed professional or telephone Medicare at 1-800-633-4227.
  • We are an independent education, research, and technology company. We are not affiliated with any Medicare plan, plan carrier, healthcare provider, or insurance company. We are not compensated for Medicare plan enrollments. We do not sell leads or share your personal information.
  • Benefits, formulary, pharmacy network, provider network, premium and/or co-payments/co-insurance may change on January 1 of each year. Our PDPCompare.com and MACompare.com provide highlights of annual plan benefit changes.
  • The benefit information provided is a brief summary, not a complete description of benefits. For more information contact the plan.
  • Limitations, copayments, and restrictions may apply.
  • We make every effort to show all available Medicare Part D or Medicare Advantage plans in your service area. However, since our data is provided by Medicare, it is possible that this may not be a complete listing of plans available in your service area. For a complete listing please contact 1-800-MEDICARE (TTY users should call 1-877-486-2048), 24 hours a day/7 days a week or consult www.medicare.gov.
    Statement required by Medicare:
    "We do not offer every plan available in your area. Any information we provide is limited to those plans we do offer in your area. Please contact Medicare.gov or 1-800-MEDICARE to get information on all of your options."
  • When enrolling in a Medicare Advantage plan, you must continue to pay your Medicare Part B premium.
  • Medicare beneficiaries with higher incomes may be required to pay both a Medicare Part B and Medicare Part D Income Related Monthly Adjustment Amount (IRMAA). Read more on IRMAA.
  • Medicare Advantage plans that include prescription drug coverage (MAPDs) are considered Medicare Part D plans and members with higher incomes may be subject to the Medicare Part D Income Related Monthly Adjustment Amount (IRMAA), just as members in stand-alone Part D plans. In certain situations, you can appeal IRMAA.
  • You must be enrolled in both Medicare Part A and Part B to enroll in a Medicare Advantage plan. Members may enroll in a Medicare Advantage plan only during specific times of the year. Contact the Medicare plan for more information.
  • If you are enrolled in a Medicare plan with Part D prescription drug coverage, you may be eligible for financial Extra Help to assist with the payment of your prescription drug premiums and drug purchases. To see if you qualify for Extra Help, call: 1-800-MEDICARE (1-800-633-4227). TTY users should call 1-877-486-2048, 24 hours a day/ 7 days a week or consult www.medicare.gov; the Social Security Office at 1-800-772-1213 between 7 a.m. and 7 p.m., Monday through Friday. TTY users should call, 1-800-325-0778; or your state Medicaid Office.
  • Medicare evaluates plans based on a 5-Star rating system. Star Ratings are calculated each year and may change from one year to the next.
  • A Medicare Advantage Private Fee-for-Service plan (PFFS) is not a Medicare supplement plan. Providers who do not contract with the plan are not required to see you except in an emergency.
  • Disclaimer for Institutional Special Needs Plan (SNP): This plan is available to anyone with Medicare who meets the Skilled Nursing Facility (SNF) level of care and resides in a nursing home.
  • Disclaimer for Dual Eligible (Medicare/Medicaid) Special Needs Plan (SNP): This plan is available to anyone who has both Medical Assistance from the State and Medicare. Premiums, co-pays, co-insurance, and deductibles may vary based on the level of Extra Help you receive. Please contact the plan for further details.
  • Disclaimer for Chronic Condition Special Needs Plan (SNP): This plan is available to anyone with Medicare who has been diagnosed with the plan specific Chronic Condition.
  • Medicare MSA Plans combine a high deductible Medicare Advantage Plan and a trust or custodial savings account (as defined and/or approved by the IRS). The plan deposits money from Medicare into the account. You can use this money to pay for your health care costs, but only Medicare-covered expenses count toward your deductible. The amount deposited is usually less than your deductible amount, so you generally have to pay out-of-pocket before your coverage begins.
  • Medicare MSA Plans do not cover prescription drugs. If you join a Medicare MSA Plan, you can also join any separate (stand-alone) Medicare Part D prescription drug plan
  • There are additional restrictions to join an MSA plan, and enrollment is generally for a full calendar year unless you meet certain exceptions. Those who disenroll during the calendar year will owe a portion of the account deposit back to the plan. Contact the plan provider for additional information.
  • Medicare beneficiaries may enroll through the CMS Medicare Online Enrollment Center located at www.medicare.gov.
  • Medicare beneficiaries can file a complaint with the Centers for Medicare & Medicaid Services by calling 1-800-MEDICARE 24 hours a day/7 days or using the medicare.gov site. Beneficiaries can appoint a representative by submitting CMS Form-1696.