Table 2.
Medicare Prescription Drug Plan Formulary Coverage and Use of Utilization Management for Individual Benzodiazepines, Non-benzodiazepine Sedative Hypnotics, and Gabapentinoids, 2017 Second Quarter
| Formulary coveragea | No coverage (%) | Unrestrictive coverage (%) | Restrictive coveragea (%) | Imposes a quantity limit (%) | Requires prior authorization (%) | Requires step therapy (%) |
|---|---|---|---|---|---|---|
| Benzodiazepines | ||||||
| Alprazolam | 11.9 | 21.9 | 67.1 | 75.7 | 7.5 | 0 |
| Chlordiazepoxide | 48.9 | 37.6 | 13.5 | 57.4 | 17.7 | 0 |
| Clonazepam | 0 | 28.8 | 71.2 | 62.2 | 22.5 | 2.1 |
| Clorazepate | 0 | 27.2 | 72.8 | 63.8 | 37.0 | 0 |
| Diazepam | 0 | 19.6 | 80.4 | 72.0 | 39.7 | 0 |
| Estazolam | 59.4 | 33.6 | 7.0 | 55.9 | 23.4 | 0 |
| Flurazepam | 56.9 | 38.2 | 4.9 | 45.2 | 17.9 | 0 |
| Lorazepam | 0 | 17.5 | 82.5 | 74.6 | 19.6 | 0 |
| Oxazepam | 33.9 | 28.6 | 37.5 | 34.6 | 28.3 | 0 |
| Quazepamb | 100 | |||||
| Temazepam | 45.2 | 22.8 | 32.0 | 63.8 | 58.5 | 0 |
| Triazolam | 60.3 | 36.5 | 3.2 | 53.3 | 13.3 | 0 |
| Non-benzodiazepine sedative hypnotics | ||||||
| Doxepin | 0 | 39.4 | 60.6 | 0 | 57.1 | 3.4 |
| Zaleplon | 23.3 | 3.8 | 72.9 | 78.6 | 54.8 | 10.0 |
| Zolpidem | 4.5 | 1.4 | 94.1 | 84.5 | 65.4 | 8.3 |
| Gabapentinoids | ||||||
| Gabapentin | 0 | 59.8 | 40.2 | 40.2 | 0 | 0 |
| Gabapentin enacarbilb | 100 | |||||
| Pregabalin | 0 | 28.6 | 71.8 | 64.0 | 16.1 | 1.1 |
aRestrictive coverage defined as use of one or more utilization management strategy: quantity limit, prior authorization requirement, and step therapy requirement
bDrug was not covered by any formulary over the study period