Does Upmc Health Network, INC. require prior authorization for Dificid?
Upmc Health Network, INC. does not require prior authorization for Dificid on the Medicare Part D plans that cover it.
No covering plan from this payer files a prior-authorization requirement for this drug.
- This drug does not appear on any of this payer's Medicare Part D formularies. That means it is NOT COVERED under those plans — which is a different and generally worse outcome than requiring prior authorization. An exception or formulary-exception request may still be possible.
- No prior authorization is filed, but step therapy applies on 8 of 8 covering plans — the plan requires another drug be tried first.
By product strength
| RxNorm product | Plans covering | Require prior auth | Step therapy | Qty limit | Status |
|---|---|---|---|---|---|
| fidaxomicin 200 MG Oral Tablet [Dificid]1111110 | 0 / 12 | 0 | 0 | 0 | Not on formulary |
| fidaxomicin 40 MG/ML Oral Suspension [Dificid]2279847 | 8 / 12 | 0 | 8 | 8 | No prior authorization |
Product names come from RxNorm (U.S. National Library of Medicine).
Plan-by-plan detail — fidaxomicin 40 MG/ML Oral Suspension [Dificid]
Dificid has 2 products in the corpus; this table is for fidaxomicin 40 MG/ML Oral Suspension [Dificid], the one carried on the most plans. The product table above covers every strength.
| Plan | Contract | Tier | Prior auth | Step therapy | Qty limit |
|---|---|---|---|---|---|
| UPMC for Life PPO High Deductible Rx (PPO) | H5533-003 | 5 | No | Yes | Yes |
| UPMC for Life PPO Rx Choice (PPO) | H5533-015 | 5 | No | Yes | Yes |
| UPMC for Life PPO Rx Choice (PPO) | H5533-015 | 5 | No | Yes | Yes |
| UPMC for Life PPO Rx Choice (PPO) | H5533-015 | 5 | No | Yes | Yes |
| UPMC for Life PPO Rx Choice (PPO) | H5533-015 | 5 | No | Yes | Yes |
| UPMC for Life PPO Rx Choice (PPO) | H5533-015 | 5 | No | Yes | Yes |
| UPMC for Life PPO Rx Enhanced (PPO) | H5533-005 | 5 | No | Yes | Yes |
| UPMC for Life PPO Rx Enhanced (PPO) | H5533-008 | 5 | No | Yes | Yes |
- Effective
- 2026-06-30
- Retrieved
- 2026-07-19
- SHA-256
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Dificid at other payers
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.