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April 2023 Medicare Drug List Updates: Thirty (30) medications added to the 2023 Medicare Part D Drug plan formularies.

Category: Monthly Formulary Changes
Published: Apr, 30 2023 12:04:10


The April 2023 Medicare Part D prescription drug plan formulary (drug list) data is now online and included in our Formulary Browser and Q1Rx Drug Finder.

The April formulary updates include the addition of 42 new National Drug Codes (NDCs), representing 30 different prescription drugs, many with multiple strengths.

The formulary updates impact both stand-alone Medicare Part D plans (PDPs) and Medicare Advantage plans with drug coverage (MAPDs).


Highlights of the April 2023 Formulary updates include seven (7) newly-introduced brand-name drugs

The April drug data updates include thirteen (13) new brand-name drugs, seven (7) of which are newly introduced brand-name drugs, some with multiple strengths. These drugs include:
  • AMJEVITA®,
  • ERMEZA®,
  • HEPLISAV-B®,
  • KRAZATI®,
  • SUNLENCA®,
  • TADLIQ®, and
  • TASCENSO ODT®.

The April 2023 Formulary updates include six (6) newly-added generic drugs

The April Medicare Part D drug data also includes seventeen (17) new generic medications, six (6) of which are newly-introduced generic drugs.  These new generic drugs include:
  • BRIMONIDINE [Mirvaso®],
  • DICLOFENAC POTASSIUM [Cambia®],
  • SODIUM OXYBATE [Xyrem®],
  • TOPIRAMATE ER [Trokendi XR®],
  • TOPIRAMATE ER [Qudexy XR®], and
  • LEUPROLIDE DEPOT.

Please note that these new generic and brand-name drugs are not available on all Medicare Part D or Medicare Advantage drug plans - and you can review the chart to see the (often limited) number of plan formularies that now include these drugs.


Reminders about Medicare prescription drug plan formulary changes
  1. Medicare Part D plans (PDPs and MAPDs) can change their formulary or drug list during the year and may drop one of your formulary medication mid-year for specific Medicare-allowable reasons (such as a new generic drug is available), but there are steps you can take if your medication is no longer covered by your prescription drug plan.

  2. In most cases, your Medicare Part D plan will notify you if the plan drops a medication you are currently using.

Good to know: What is the NDC?

The NDC or National Drug Code is used to uniquely identify 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 drug manufacturer, the second set of number identifies the product and strength, and the third set of numbers identifies the packaging.  You can read more here: Q1FAQ.com/155


Summary of April 2023 NDC changes

There are many reasons for NDCs to be added to the Medicare Part D program, a summary for all 42 new April 2023 NDCs is as follows:

Reason for NDC Addition Occurrences
New Delivery Form and Strength1
New Drug15
New Drug and Delivery Form1
New Drug and Strength14
New Manufacturer and Delivery Form2
New Manufacturer and Strength5
New Manufacturer, Strength and Delivery Form1
New Strength3
Grand Total42

The following chart details the 42 new manufacturer / drug-strength / packaging combinations (NDCs) that were added to one or more Medicare Part D formularies in the most recent updates -- as you will notices, some drugs are only covered by a few Medicare plans.

You can click on the Drug Name below to go to our Q1Medicare.com Drug Finder (Q1Rx.com) and see the details of how this drug is covered by all Medicare Part D plans (PDPs) in Florida (our example state).  You can then change the state in our search form for details of drug coverage in your service area.


NDC Drug Name Number of
PDP Formularies*
Number of
MAPD Formularies*
Notes
55513041101 AMJEVITA 20 MG/0.4 ML SYRINGE 6 35 New Drug and Strength
55513040002 AMJEVITA 40 MG/0.8 ML AUTO INJCT 6 35 New Drug and Delivery Form
55513041001 AMJEVITA 40 MG/0.8 ML SYRINGE 6 33 New Drug and Strength
00078072910 BETOPTIC S 0.25% EYE DROP EYE DROPPER 20 164 New Drug
45802007830 BRIMONIDINE 0.33% GEL PUMP GEL W/PUMP [Mirvaso] 4 21 New Drug
00069765430 CADUET 10 MG-40 MG TABLET 0 2 New Strength
00069747630 CADUET 10 MG-80 MG TABLET 0 2 New Strength
00121064908 CIMETIDINE 300 MG/5 ML SOLUTION 19 249 New Manufacturer, Strength and Delivery Form
16714016101 CLINDAMYCIN PH 1% GEL [ClindaMax] 43 315 New Manufacturer and Delivery Form
24979000106 DEXLANSOPRAZOLE DR 30 MG CAPSULE DR BP [Kapidex] 21 86 New Manufacturer and Strength
31722004632 DICLOFENAC POTASSIUM 50 MG POWDER PACKET [Cambia] 1 12 New Drug
43598058811 DIFLUPREDNATE 0.05% EYE DROPS [Durezol] 43 311 New Drug
00548560500 ENOXAPARIN 100 MG/ML SYRINGE [Lovenox] 62 391 New Manufacturer and Strength
00548560300 ENOXAPARIN 60 MG/0.6 ML SYRINGE [Lovenox] 62 391 New Manufacturer and Strength
49502037875 ERMEZA 150 MCG/5 ML SOLUTION 0 8 New Drug
00143928901 ESTRADIOL 50 MG/5 ML VIAL [Delestrogen] 40 218 New Manufacturer and Strength
43528000301 HEPLISAV-B 20 MCG/0.5 ML SYRINGE 56 379 New Drug
80739081218 KRAZATI 200 MG TABLET 62 391 New Drug
69097090950 LEUPROLIDE DEPOT 22.5 MG VIAL 37 239 New Drug
65862094424 LEVALBUTEROL 0.63 MG/3 ML SOL VIAL-NEB [Xopenex] 12 242 New Manufacturer and Strength
00480413806 LUBIPROSTONE 24 MCG CAPSULE [Amitiza] 43 274 New Drug and Strength
00480347906 LUBIPROSTONE 8 MCG CAPSULE [Amitiza] 43 274 New Drug and Strength
50742031025 MAFENIDE ACETATE 50 GM POWDER PACKET 4 25 New Drug
72888002407 POTASSIUM CL 20 MEQ PACKET [Klor-Con] 26 259 New Drug
00078077803 NEVANAC 0.1% EYE DROP EYE DROPPER 4 56 New Drug
00169418113 OZEMPIC 0.25-0.5 MG/DOSE PEN PEN INJCTR 53 372 New Strength
00781215832 PIRFENIDONE 267 MG CAPSULE [ESBRIET] 50 351 New Manufacturer and Delivery Form
00065414727 SIMBRINZA 1%-0.2% EYE DROP EYE DROPPER 40 328 New Drug
00054962857 SODIUM OXYBATE 0.5 G/ML SOLUTION [Xyrem] 35 323 New Drug
61958300101 SUNLENCA 4-300 MG TABLET 62 388 New Drug and Strength
61958300102 SUNLENCA 5-300 MG TABLET 62 388 New Drug and Strength
46287004515 TADLIQ 20 MG/5 ML ORAL SUSPENSION 3 45 New Drug
70709006530 TASCENSO ODT 0.5 MG TABLET RAPDIS 1 64 New Drug
68462037430 TOPIRAMATE ER 100 MG CAPSULE SPR 24 [Qudexy XR] 1 67 New Drug and Strength
68462037030 TOPIRAMATE ER 150 MG CAPSULE SPR 24 [Qudexy XR] 1 67 New Drug and Strength
68462037130 TOPIRAMATE ER 200 MG CAPSULE SPR 24 [Qudexy XR] 1 67 New Drug and Strength
68462037230 TOPIRAMATE ER 25 MG CAPSULE SPR 24 [Qudexy XR] 1 67 New Drug and Strength
68462037330 TOPIRAMATE ER 50 MG CAPSULE SPR 24 [Qudexy XR] 1 67 New Drug and Strength
68382076906 TOPIRAMATE ER 100 MG CAPSULE ER 24H [Trokendi XR] 4 21 New Drug and Strength
68382086306 TOPIRAMATE ER 25 MG CAPSULE ER 24H [Trokendi XR] 4 21 New Drug and Strength
68382086406 TOPIRAMATE ER 50 MG CAPSULE ER 24H [Trokendi XR] 4 21 New Drug and Strength
00574222545 TRETINOIN 0.025% CREAM (G) [Tretin-X] 62 391 New Delivery Form and Strength




If your brand-name drug is no longer covered by your Medicare Part D plan, you can use the 30-day notice period (if notice is provided) to:
  • Ask your prescriber about trying the generic.

  • Check for an alternative formulary drug.

  • Ask your plan to cover a non-formulary drug. 
    You will need to work with your doctor or prescriber to explain why you are not able to use the generic medication or why no other formulary drug is acceptable.  If your formulary exception is denied, you have the right to appeal your plan’s decision.

  • Consider using a Special Enrollment Period and move to another Medicare plan that provides coverage of all your prescription and health needs.
Learn more in our article: How a mid-year formulary change can affect your Medicare Part D drug coverage.

Our online Formulary Browser and Drug Finder

You can review any Medicare plan formulary using the Q1Medicare.com Formulary Browser found at: FormularyBrowser.com or compare how any medication is covered on all Medicare plans in your Service Area using our Drug Finder found at: Q1Rx.com.







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