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September 2019 Formulary Changes to the Top Medicare Drugs

Category: Monthly Formulary Changes
Published: Sep, 17 2019 01:09:46

The September 2019 Medicare Part D plan formulary (or drug list) updates included included 43 new drug codes or NDCs representing 34 different medications, including 20 new generics.

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®], Risedronate Sodium [Actonel®], Quetiapine Fumarate [Seroquel®], and Valsartan-HCTZ [Diovan HCT®]. 

The changes to the number of formularies covering these medications looks as follows:

Count of 2019 Formularies Covering the Top Medicare Drugs Program-wide
    Formulary Count*
Drug Name 2014 End** 2015 End** 2016 End** 2017 End** 2018 End** 2019
April May June July Aug. Sep.
ACTONEL 35 MG 36 DOSE PACK 248 148 25 11 13 8 8 9 9 8 8 8
ACTOS 30MG TABLET 75 35 23 16 16 18 16 17 17 16 16 16
ADVAIR DISKUS MIS 250/50 347 353 348 371 370 393 386 378 366 363 361 361
ATORVASTATIN 10 MG TABLET [Lipitor] 364 394 385 389 394 415 407 410 407 408 406 406
CLOPIDOGREL TAB 75MG [Plavix] 364 394 385 389 394 415 407 410 407 408 406 406
DIOVAN HCT 160/12.5MG TABLET 80 50 29 21 54 19 17 18 18 17 17 17
ESCITALOPRAM 10 MG TABLET [Lexapro] 363 385 385 389 394 415 407 410 308 408 406 406
ESOMEPRAZOLE SODIUM 40 MG VIAL [Nexium] 253 285 302 305 315 299 300 309 308 309 309 309
LANTUS 100U/ML VIAL 350 382 371 382 309 315 307 310 307 308 306 306
LEXAPRO 10MG TABLET 55 45 26 12 21 16 14 15 15 14 14 14
LIPITOR 10MG TABLET 43 30 21 20 21 21 19 20 20 19 19 19
NEXIUM 40MG CAPSULE 211 206 98 33 19 20 19 19 19 19 19 19
PIOGLITAZONE HCL 30 MG TABLET [Actos] 364 394 385 389 394 415 407 410 407 408 406 406
PLAVIX 75MG TABLET 48 34 20 13 16 11 9 10 10 9 9 9
QUETIAPINE FUMARATE 25 MG TAB [SEROQUEL] 364 394 385 389 394 415 407 410 407 408 406 406
RISEDRONATE SODIUM 35 MG TABLET [Actonel]   220 246 239 249 289 288 290 287 289 287 287
SEROQUEL 25MG TABLET 54 43 26 12 14 11 9 10 10 9 9 9
VALSARTAN-HCTZ 160-12.5 MG TAB [Diovan HCT] 343 388 376 382 391 412 404 407 404 405 403 403

*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).

**Ending 2014 CMS formulary dataset dated September, 2014. Ending 2015 CMS formulary dataset dated September, 2015. Ending 2016 CMS formulary dataset dated September, 2016. Ending 2017 CMS formulary dataset dated September, 2017. Ending 2018 CMS formulary dataset dated September, 2018. Starting 2019 CMS formulary dataset dated October, 2018 (version 2).

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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