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Summary of the 2016 Medicare Part D Formulary Coverage for the Top 10 Medicare Drugs Compared to Previous Years

Monthly Formulary changes · published Oct 26, 2015

The 2016 Medicare Part D plan formulary data (or drug lists) released in October 2015 included 167 new drug codes.  See October 2015 Summary of the new Medications added to Medicare Part D Plan Formularies (Drug Lists) for January 2016 for details.

Although this blog is about the top 10 Medicare drugs, we include some of the newer generic equivalents to the list, thus bringing our list to include 17 drugs.  The generics included are Atorvastatin [Lipitor®] , Clopidogrel [Plavix®] (see change in manufacturer below), Escitalopram [Lexapro®], Esomeprazole Sodium [Nexium®], Pioglitazone [Actos®], Quetiapine Fumarate [Seroquel®], and Valsartan-HCTZ [Diovan HCT®]. 

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

Count of 2016 Formularies covering the Top 10 Medicare Drugs Program wide
Formulary Count*
NDC Drug Name 2013 End** 2014 End** 2015 Start** 2015 End** 2016 Start** April May June July Aug.
00430047203 ACTONEL 35 MG 36 DOSE PACK 233 248 140 148 39
64764030115 ACTOS 30MG/1 TABLET (90 CT) 214 75 32 35 22
00173069600 ADVAIR DISKUS MIS 250/50 307 347 313 353 344
63304082790 ATORVASTATIN 10 MG TABLET [Lipitor] 316 364 350 394 377
00378362777 CLOPIDOGREL TAB 75MG [Plavix] 315 364 350
55111019630 CLOPIDOGREL TAB 75MG [Plavix] 394
00093731456 CLOPIDOGREL TAB 75MG [Plavix] 377
00078031534 DIOVAN HCT 160/12.5MG TABLET 185 80 47 50 28
00093585101 ESCITALOPRAM 10 MG TABLET [Lexapro] 315 363 349 385 377
47335050944 ESOMEPRAZOLE SODIUM 40 MG VIAL [Nexium] 253 235 285
62756050944 ESOMEPRAZOLE SODIUM 40 MG VIAL [Nexium] 285 288
00088222033 LANTUS 100U/ML VIAL 309 350 338 382 363
00456201001 LEXAPRO 10MG TABLET 92 55 31 45 20
00071015523 LIPITOR 10MG TABLET 68 43 28 30 20
00186504054 NEXIUM 40MG CAPSULE 198 211 156 206 84
00378022893 PIOGLITAZONE HCL 30 MG TABLET [Actos] 310 364 350 394 377
63653117105 PLAVIX 75MG TABLET 109 48 31 34 19
47335090288 QUETIAPINE FUMARATE 25 MG TAB [SEROQUEL] 316 364 350 394 377
00310027510 SEROQUEL 25MG TABLET 112 54 29 43 20
00378632205 VALSARTAN-HCTZ 160-12.5 MG TAB [Diovan HCT] 297 343 332 388 368

*The formulary counts include both stand-alone prescription drug plans (PDP) and Medicare Advantage plans (MAPD) in all states and the U.S. territories.
**Ending 2013 CMS formulary dataset dated October, 2013. Ending 2014 CMS formulary dataset dated September, 2014. Starting 2015 CMS formulary dataset dated October, 2014. Ending 2015 CMS formulary dataset dated September, 2015. Starting 2016 CMS formulary dataset dated October, 2015 (Sanctioned plans not included in plan count).

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