Benefily
Varies by plan

Does Priority Health require prior authorization for Drizalma?

Prior authorization for Drizalma differs across Priority Health's Medicare Part D plans and product strengths — 3 of 4 Drizalma products in the corpus appear on their formularies, and the requirement is not uniform. Check the member's specific plan.

Some plans require authorization and others do not. The member's specific plan decides.

By product strength

RxNorm productPlans coveringRequire prior authStatus
Sprinkle duloxetine 20 MG Delayed Release Oral Capsule [Drizalma]220017437 / 3737Prior authorization required
Sprinkle duloxetine 30 MG Delayed Release Oral Capsule [Drizalma]220017737 / 3737Prior authorization required
Sprinkle duloxetine 40 MG Delayed Release Oral Capsule [Drizalma]22001800 / 370Not on formulary
Sprinkle duloxetine 60 MG Delayed Release Oral Capsule [Drizalma]220018337 / 3737Prior authorization required

Product names come from RxNorm (U.S. National Library of Medicine).

Source
Monthly Prescription Drug Plan Formulary and Pharmacy Network Information — Basic Drugs Formulary File
Effective
2026-06-30
Retrieved
2026-07-19
SHA-256
e626e6bcda1aa6a0071e6f0df6bafe686ae41842cdf0a9feffdc649b6d3ff3ae

We publish the hash of the exact file we ingested so any answer can be audited against the bytes CMS served that day.

Drizalma at other payers

Or see Drizalma across every payer at once.

Administrative information only. Benefily reports what a payer has published in its own prior-authorization policy as of the effective date shown. It is not medical advice, not a coverage or payment guarantee, and not an authorization. Requirements vary by plan, place of service and member benefits — always verify with the payer before rendering service.