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September 2020 Formulary Changes to the Top Medicare Drugs

Category: Monthly Formulary Changes
Published: Sep, 29 2020 05:09:24


The September 2020 Medicare Part D plan formulary (or drug list) updates included 86 new drug codes or NDCs representing 46 different medications, including 18 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 2020 Formularies Covering the Top Medicare Drugs Program-wide
    Formulary Count*
Drug Name 2015 End** 2016 End** 2017 End** 2018 End** 2019 End** 2020
Start**
April May June July Aug. Sep.
ACTONEL 35 MG TABLET 148 25 11 13 8 11 11 11 11 11 11  11
ACTOS 30 MG TABLET 35 23 16 16 16 15 15 15 15 15 15  15
ADVAIR DISKUS MIS 250/50 353 348 371 370 361 310 294 303 304 311 311  312
ATORVASTATIN 10 MG TABLET [Lipitor] 394 385 389 394 406 454 445 443 447 454 454  454
CLOPIDOGREL 75 MG TABLET [Plavix] 394 385 389 394 406 454 445 443 447 454 454  454
DIOVAN HCT 160/12.5MG TABLET 50 29 21 54 17 18 18 18 18 18 18  18
ESCITALOPRAM 10 MG TABLET [Lexapro] 385 385 389 394 406 454 445 443 447 454 454  454
ESOMEPRAZOLE MAG DR 40 MG CAP [Nexium] 285 302 305 315 309 352 341 341 343 352 352  353
LANTUS 100U/ML VIAL 382 371 382 309 306 363 356 355 358 364 364  364
LEXAPRO 10MG TABLET 45 26 12 21 14 12 12 12 12 12 12  12
LIPITOR 10MG TABLET 30 21 20 21 19 16 16 16 16 16 16  16
NEXIUM DR 40 MG CAPSULE 206 98 33 19 19 10 10 10 10 10 10  10
PIOGLITAZONE HCL 30 MG TABLET [Actos] 394 385 389 394 406 454 445 443 447 454 454  454
PLAVIX 75 MG TABLET 34 20 13 16 75 10 10 10 10 10 10  10
QUETIAPINE FUMARATE 25 MG TAB [Seroquel] 394 385 389 394 406 454 445 443 447 454 454  454
RISEDRONATE SODIUM 35 MG TAB [Actonel] 220 246 239 249 287 337 328 325 328 335 335  335
SEROQUEL 25MG TABLET 43 26 12 14 9 10 10 10 10 10 10  10
VALSARTAN-HCTZ 160-12.5 MG TABLET [Diovan HCT] 388 376 382 391 403 451 442 441 444 451 451  451

*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 CMS formulary dataset are the September dataset. The starting 2020 CMS formulary dataset is dated October, 2019.

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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