How Much Does Farxiga (Dapagliflozin) Cost in District of Columbia in 2026?

Farxiga Retail Pricing in DC Without Insurance

The cash price for a 30-day supply of brand-name Farxiga 10 mg at DC retail pharmacies averages $620 per month in 2026. That figure reflects AstraZeneca's wholesale acquisition cost passed through to consumers who pay entirely out of pocket. Prices at individual pharmacies, including chains like CVS, Walgreens, and independent DC pharmacies, may vary by $20 to $50 depending on dispensing fees and markup.

No FDA-approved generic dapagliflozin exists as of May 2026. AstraZeneca holds patent protections on Farxiga that extend through at least 2027, according to FDA Orange Book listings. That patent exclusivity keeps DC retail pricing tethered to AstraZeneca's list price. Patients without insurance or coupon assistance face the full $620 monthly cost.

Pharmacy benefit managers (PBMs) negotiate confidential rebates with AstraZeneca, but those rebates reduce the insurer's net cost rather than the patient's sticker price. A DC resident walking into a pharmacy with no coverage pays the unreduced amount. GoodRx and similar discount aggregators may shave 5% to 15% off the cash price at certain DC locations, though availability changes month to month.

Dapagliflozin belongs to the sodium-glucose co-transporter 2 (SGLT2) inhibitor class. Three SGLT2 inhibitors are on the US market: dapagliflozin (Farxiga), empagliflozin (Jardiance), and canagliflozin (Invokana). All three carry comparable list prices. The DAPA-HF trial (N=4,744) demonstrated that dapagliflozin 10 mg reduced the composite of worsening heart failure or cardiovascular death by 26% versus placebo in patients with heart failure and reduced ejection fraction (HR 0.74; 95% CI 0.65-0.85; P<0.001). That evidence base drives formulary placement and, by extension, pricing use.

DC Medicaid Coverage for Farxiga

District of Columbia Medicaid covers Farxiga with prior authorization. The DC Department of Health Care Finance (DHCF) manages the Medicaid drug benefit through its fee-for-service program and through managed care organizations (MCOs) like AmeriHealth Caritas and CareFirst Community Health Plan.

To obtain prior authorization, prescribers must document at least one of the three FDA-approved indications: type 2 diabetes mellitus, heart failure with reduced ejection fraction, or chronic kidney disease (CKD) at risk of progression. For the diabetes indication, DC Medicaid typically requires documentation that the patient has tried or has a contraindication to metformin before approving an SGLT2 inhibitor. The American Diabetes Association Standards of Care recommend SGLT2 inhibitors as add-on therapy for patients with type 2 diabetes who have established atherosclerotic cardiovascular disease, heart failure, or CKD, regardless of A1C level.

For heart failure and CKD indications, prior authorization requirements tend to be less restrictive. The DAPA-CKD trial (N=4,304) showed dapagliflozin reduced the composite of sustained decline in eGFR of 50% or greater, end-stage kidney disease, or renal/cardiovascular death by 39% versus placebo (HR 0.61; 95% CI 0.51-0.72; P<0.001). That trial enrolled patients with CKD regardless of diabetes status, and the FDA expanded Farxiga's label in April 2021 to include CKD accordingly.

DC Medicaid enrollees approved through prior authorization pay $0 to $3 per prescription, depending on their benefit tier. The authorization typically lasts 12 months before renewal documentation is required.

How the AstraZeneca Savings Card Works in DC

AstraZeneca offers a manufacturer copay savings card that reduces out-of-pocket costs to as low as $0 per month for eligible commercially insured patients. The card is not valid for patients on government insurance, including Medicare, Medicaid, TRICARE, or the DC HealthCare Alliance.

Eligibility requirements are straightforward. The patient must have commercial (private) insurance that covers Farxiga, even with a high copay. The savings card then covers the remaining copay up to a specified annual maximum, which AstraZeneca has set at $3,600 per calendar year in recent program iterations. For a patient whose insurer sets a $150 monthly copay, the card would absorb that cost entirely, and the patient pays $0 at the pharmacy counter.

DC residents can enroll online at the AstraZeneca patient portal or receive a card directly from their prescriber. Activation takes minutes. The card works at all major DC chain pharmacies and most independents. One common mistake: patients present the card without first running the claim through their insurance. The savings card is a secondary payer; the primary insurer must adjudicate first.

For uninsured DC patients, AstraZeneca operates a separate Patient Assistance Program (PAP) that provides Farxiga at no cost to qualifying individuals. Income thresholds typically fall at or below 300% of the federal poverty level ($47,520 for an individual in 2026). The PAP ships medication directly to the prescriber's office or the patient's home. Processing takes two to four weeks after application submission.

Commercial Insurance Coverage in DC

Most commercial plans available through DC Health Link (the District's ACA marketplace) and employer-sponsored plans include at least one SGLT2 inhibitor on their formularies. Whether Farxiga or its competitor empagliflozin (Jardiance) gets preferred status varies by plan and PBM.

CareFirst BlueCross BlueShield, the dominant insurer in the DC market, places Farxiga on its specialty or non-preferred brand tier for most plan designs. That means a copay of $50 to $150 per month before any manufacturer coupon is applied. Aetna and UnitedHealthcare plans sold in DC follow similar tiering, though specific copays depend on the metal level (bronze, silver, gold, platinum) of the selected plan.

Step therapy is common. Many DC commercial formularies require a trial of metformin (and sometimes a sulfonylurea or DPP-4 inhibitor) before covering an SGLT2 inhibitor for the type 2 diabetes indication. The CREDENCE trial (N=4,401) and DAPA-CKD data have shifted some formularies to waive step therapy for CKD patients, recognizing the independent renal benefit of SGLT2 inhibitors.

Patients denied coverage on initial submission should request a formulary exception. Success rates increase when the prescriber attaches clinical documentation showing that the patient meets one of the FDA-approved indications and has a clinical reason to use dapagliflozin specifically over the plan's preferred SGLT2 inhibitor.

Compounded Dapagliflozin in DC: Legality and Cost

Compounded dapagliflozin is legal in the District of Columbia through licensed 503A compounding pharmacies. Section 503A of the Federal Food, Drug, and Cosmetic Act permits pharmacies to compound medications for individual patients based on a valid prescription, provided they use bulk pharmaceutical-grade ingredients and operate within state (or District) licensing requirements.

DC's Board of Pharmacy regulates compounding pharmacies under Title 17 of the DC Municipal Regulations. A 503A pharmacy in DC can prepare dapagliflozin capsules or suspensions for patients who need a non-standard dose, an alternative dosage form (for example, a patient who cannot swallow tablets), or who seek a lower-cost alternative to the brand product.

Pricing for compounded dapagliflozin varies by pharmacy. Some DC-area 503A compounders and mail-order compounding pharmacies licensed to ship to DC residents quote prices significantly below the $620 brand cost. However, a few caveats apply. Compounded products do not undergo FDA bioequivalence testing, so absorption may differ from the brand tablet. The FDA's guidance on compounding emphasizes that compounded drugs are not FDA-approved and should be used when a medical need cannot be met by a commercially available product.

Prescribers comfortable with compounded dapagliflozin should specify the dose, dosage form, and quantity on the prescription. Insurance plans, including DC Medicaid, generally do not cover compounded versions of commercially available brand drugs. Patients choosing this route pay cash.

Telehealth Prescribing of Farxiga in DC

DC permits telehealth prescribing of Farxiga. The District of Columbia's telehealth regulations, updated through the COVID-era expansions and made permanent under DC Act 24-744, allow physicians, nurse practitioners, and physician assistants licensed in DC to prescribe medications after a synchronous audio-video visit without requiring an in-person encounter first.

Dapagliflozin is not a controlled substance, so it faces no DEA-related telehealth restrictions. A prescriber licensed in DC (or holding a DC telehealth registration, as required for out-of-state providers treating DC patients) can evaluate the patient, review labs, confirm an appropriate indication, and send the prescription electronically to any DC pharmacy.

Patients initiating dapagliflozin should have baseline labs: serum creatinine, eGFR, potassium, and blood glucose. The Kidney Disease: Improving Global Outcomes (KDIGO) 2024 guidelines recommend monitoring kidney function within two to four weeks of starting an SGLT2 inhibitor and tolerating an initial eGFR dip of up to 30% without discontinuing. Telehealth platforms operating in DC can order labs at Quest, Labcorp, or hospital-affiliated draw sites across the District.

HealthRX offers telehealth consultations for DC residents considering dapagliflozin. Patients complete an intake, provide recent lab results, and meet with a licensed provider who determines whether Farxiga is clinically appropriate.

Strategies to Reduce Farxiga Cost in DC

Several approaches can bring the effective monthly cost well below $620.

AstraZeneca savings card. For commercially insured patients, this is the fastest path to $0 per fill. Apply online or through your prescriber.

DC Medicaid. If eligible, enroll through the DC Department of Human Services. Once approved, Farxiga costs $0 to $3 per month with prior authorization.

AstraZeneca Patient Assistance Program. Uninsured or underinsured patients earning below 300% FPL can receive Farxiga at no cost. Applications require proof of income and a signed prescriber statement.

Pharmacy discount cards. GoodRx, RxSaver, and SingleCare may reduce the cash price by $30 to $90 at select DC pharmacies. These cards do not stack with insurance but can help uninsured patients who do not qualify for the PAP.

Compounded dapagliflozin. Legal in DC through 503A pharmacies. Costs vary but may be substantially lower than brand. Discuss with your prescriber whether a compounded formulation is appropriate for your clinical situation.

Formulary exception requests. If your insurer covers Jardiance but not Farxiga, your prescriber can file a medical necessity exception citing specific clinical reasons for dapagliflozin, such as enrollment in a clinical trial that used dapagliflozin or a documented adverse reaction to empagliflozin.

Clinical Value: Why Prescribers Choose Dapagliflozin

Cost decisions do not happen in a vacuum. Prescribers weigh formulary economics against clinical evidence. Dapagliflozin has three FDA-approved indications backed by large outcomes trials.

For type 2 diabetes, the DECLARE-TIMI 58 trial (N=17,160) showed dapagliflozin did not increase major adverse cardiovascular events versus placebo and reduced hospitalization for heart failure by 27% (HR 0.73; 95% CI 0.61-0.88). The trial enrolled a broad population, including patients with multiple cardiovascular risk factors but no prior events.

For heart failure, DAPA-HF established dapagliflozin as a guideline-directed medical therapy. The 2022 AHA/ACC/HFSA Heart Failure Guidelines give SGLT2 inhibitors a Class I recommendation for patients with HFrEF, regardless of diabetes status. Dr. John McMurray, lead investigator of DAPA-HF, stated: "The benefits of dapagliflozin were consistent across the full spectrum of ejection fraction and were additive to standard therapy, including sacubitril-valsartan."

For CKD, DAPA-CKD demonstrated renal protection across diabetic and non-diabetic kidney disease. The KDIGO 2024 guidelines recommend SGLT2 inhibitors for patients with CKD and an eGFR of 20 to 45 mL/min/1.73 m², or eGFR 45 to 90 with urine albumin-to-creatinine ratio above 200 mg/g.

Dr. Hiddo Heerspink, lead investigator of DAPA-CKD, noted: "SGLT2 inhibitors represent the most significant advance in CKD treatment in over two decades, with benefits that extend well beyond glucose control."

These trial results mean that for many DC patients, the question is not whether to use an SGLT2 inhibitor but how to make it affordable.

Medicare Part D and Farxiga in DC

DC residents on Medicare Part D face a different cost structure. The AstraZeneca savings card is not valid for Medicare beneficiaries. Part D plans set their own formulary tiers and cost-sharing. In 2026, the Inflation Reduction Act's $2,000 annual out-of-pocket cap on Part D prescription spending applies. Once a Medicare beneficiary's true out-of-pocket costs reach $2,000 across all covered medications in a calendar year, they pay $0 for the remainder of the year.

For a Medicare Part D enrollee whose plan covers Farxiga on a specialty tier at 25% coinsurance, the monthly cost would be approximately $155 until the $2,000 cap is reached, likely within the first year. After reaching the cap, all subsequent fills are $0. Medicare beneficiaries should verify their specific plan's formulary at Medicare.gov Plan Finder before the annual enrollment period.

Some DC-area Medicare Advantage plans offered by Kaiser Permanente and CareFirst may place Farxiga on a preferred brand tier with lower cost-sharing. Comparing plans during open enrollment (October 15 through December 7) is the single most effective cost-reduction strategy for Medicare beneficiaries taking Farxiga.