Medicare drug coverage

Dapagliflozin: 2027 Medicare Part D coverage

5,495 of 5,495 Part D plans (100%) list dapagliflozin on their 2027 formulary, the same share as 2026. 97% of those require prior authorization, step therapy, or a quantity limit.

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2027 compared with 2026

Dapagliflozin is number 193 by total Medicare Part D spending in 2024 ($202 million). Plans that list it most often put it on tier 3. Counts use 5 RxNorm products for this name.

dapagliflozin Part D coverage, 2026 and 2027
Measure20262027Change
Part D plans in the file5,5185,495-23
Plans that list it5,517 (100%)5,495 (100%)no change
Prior authorization (of plans that list it)0 (0%)0 (0%)no change
Step therapy (of plans that list it)0 (0%)55 (1%)+1 point
Quantity limit (of plans that list it)5,332 (97%)5,355 (97%)+1 point
Any of the three (of plans that list it)5,332 (97%)5,355 (97%)+1 point
Not listed or restricted (of all plans)5,333 (97%)5,355 (97%)+1 point

Source: CMS 2027 Part D formulary file (basic drugs and plan information), as of October 8, 2026. Publisher page

Source: CMS 2026 Part D formulary file (basic drugs and plan information), as of September 30, 2026. Publisher page

Formulary tier

dapagliflozin formulary tier, 2026 and 2027
Tier2026 plans2027 plans
Tier 12,032 (37%)2,339 (43%)
Tier 2505 (9%)645 (12%)
Tier 32,955 (54%)2,503 (46%)
Tier 625 (0%)8 (0%)

Source: CMS 2027 Part D formulary file (basic drugs and plan information), as of October 8, 2026. Publisher page

Source: CMS 2026 Part D formulary file (basic drugs and plan information), as of September 30, 2026. Publisher page

Plan by plan, 2026 to 2027

4,380 plan ids are in both files. 54 of them (1%) added prior authorization, step therapy, or a quantity limit for dapagliflozin, and 0 stopped listing it.

dapagliflozin: plans in both 2026 and 2027
Plan by planPlans
Same plan id in both years4,380
Listed it in 2026, not in 20270 (0%)
Listed it in 2027, not in 20260 (0%)
Moved it to a higher tier74 (2%)
Added prior authorization0 (0%)
Added step therapy30 (1%)
Added a quantity limit24 (1%)
Added at least one of the three54 (1%)
Removed at least one of the three1 (0%)
Plan ids new in 20271,115
2026 plan ids not in the 2027 file1,138

Source: CMS 2027 Part D formulary file (basic drugs and plan information), as of October 8, 2026. Publisher page

Source: CMS 2026 Part D formulary file (basic drugs and plan information), as of September 30, 2026. Publisher page

States from most to least restrictive

Share of 2027 Part D plans offered in each state that leave dapagliflozin off the formulary or list it with prior authorization, step therapy, or a quantity limit. South Dakota ranks first at 100%, with 20% of its plans using prior authorization or step therapy; Maryland ranks last at 80%. Ties break on the prior authorization or step therapy share.

States from most to least restrictive for dapagliflozin, 2027
RankState2027 plansNot listed or restrictedPrior auth or step therapyChange from 2026
1South Dakota30100%20%no change
2Minnesota63100%16%no change
3North Dakota26100%15%no change
4Ohio173100%9%no change
5Nebraska51100%4%no change
6Delaware43100%2%no change
7Alabama115100%2%no change
8Pennsylvania324100%1%no change
9South Carolina91100%1%no change
10Mississippi105100%1%no change
11Arizona148100%1%no change
12Tennessee157100%1%no change
13North Carolina177100%1%no change
14Texas412100%0%no change
15Alaska9100%0%no change
16Arkansas86100%0%no change
17Connecticut54100%0%+4 points
18Florida549100%0%no change
19Iowa64100%0%no change
20Idaho45100%0%no change
21Illinois133100%0%no change
22Indiana140100%0%no change
23Kansas84100%0%no change
24Kentucky123100%0%no change
25Louisiana126100%0%no change
26Massachusetts92100%0%+29 points
27Maine52100%0%no change
28Michigan183100%0%no change
29Missouri171100%0%no change
30Montana27100%0%no change
31New Hampshire25100%0%no change
32New Jersey74100%0%no change
33New Mexico68100%0%no change
34Oklahoma81100%0%no change
35Rhode Island29100%0%no change
36Utah53100%0%no change
37Vermont14100%0%no change
38West Virginia70100%0%no change
39Wyoming13100%0%no change
40Wisconsin9799%0%no change
41Nevada10097%0%-3 points
42Virginia14596%0%no change
43Oregon9296%0%+4 points
44Georgia15195%0%no change
45Colorado10690%0%+3 points
46Hawaii5088%0%+1 point
47California39788%0%no change
48New York21587%0%+2 points
49Washington11486%2%+4 points
50District of Columbia2186%0%-2 points
51Maryland4980%2%-5 points

Source: CMS CY2027 landscape file (states and parent organizations), as of September 30, 2026. Publisher page

Source: CMS 2027 Part D formulary file (basic drugs and plan information), as of October 8, 2026. Publisher page

By parent organization

164 parent organizations offer 2027 Part D plans. Humana Inc. has the most, 884, and 100% of them leave dapagliflozin off or restrict it.

dapagliflozin coverage by parent organization, 2027
Parent organization2027 plans ↓List itRestrict it (of listing)Not listed or restrictedChange from 2026Plans that added a restriction
Humana Inc.884100%100%100%no change0
UnitedHealth Group, Inc.850100%100%100%no change0
Devoted Health, Inc.728100%100%100%no change0
CVS Health Corporation633100%100%100%no change0
Elevance Health, Inc.294100%100%100%no change0
Centene Corporation268100%100%100%no change0
Health Care Service Corporation231100%100%100%no change8
Kaiser Foundation Health Plan, Inc.112100%0%0%no change0
Highmark Health98100%100%100%no change0
SCAN Group85100%100%100%no change0
Alignment Healthcare USA, LLC77100%100%100%no change0
Guidewell Mutual Holding Corporation55100%100%100%+4 points2
Blue Cross Blue Shield of Michigan Mutual Ins. Co.43100%100%100%no change0
Molina Healthcare, Inc.43100%100%100%no change0
Corewell Health40100%100%100%no change0
Zing Health Consolidator, Inc36100%100%100%no change0
CAPITAL BLUE CROSS35100%100%100%no change0
Medica Holding Company31100%100%100%no change5
UPMC Health System30100%100%100%no change0
Universal Health Services, Inc.29100%100%100%no change0
MHH Healthcare, L.P.26100%100%100%no change0
Independence Health Group, Inc.25100%100%100%no change0
Point32Health, Inc.23100%100%100%+100 points19
BlueCross BlueShield of Tennessee22100%100%100%no change0
California Physicians' Service22100%100%100%no change0

Source: CMS CY2027 landscape file (states and parent organizations), as of September 30, 2026. Publisher page

Source: CMS 2027 Part D formulary file (basic drugs and plan information), as of October 8, 2026. Publisher page

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Other Dapagliflozin Propanediol products

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About this data

A plan here is one Part D plan as the CMS formulary files list it: contract, plan, and segment. That covers Medicare Advantage plans with drug coverage and stand-alone drug plans. A plan lists a drug when its formulary has a row for any RxNorm product of that name. When it has several, the row with the lowest tier is the one counted, and restricted means that row has prior authorization, step therapy, or a quantity limit.

A plan with no row for the drug counts as not listing it. That can be a product the file codes another way, so read a low count as a lookup result, not a coverage decision. A state counts every plan the CMS landscape file offers there. Parent organizations are named as CMS names them. The drug list is the top 200 by total Part D spending.

Source: CMS 2027 Part D formulary file (basic drugs and plan information), as of October 8, 2026. Publisher page

Source: CMS CY2027 landscape file (states and parent organizations), as of September 30, 2026. Publisher page

Source: CMS Medicare Part D Spending by Drug, 2024 data, as of June 25, 2026. Publisher page

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