Farxiga Cost in New Jersey 2026: Cash Price, Insurance, Medicaid, and Compounding Options

What Does Farxiga Actually Cost at New Jersey Pharmacies in 2026?

The manufacturer (AstraZeneca) sets a list price of approximately $620 per month for a 30-tablet supply of Farxiga 10 mg in the United States, and New Jersey retail pharmacies reflect that figure at the counter for uninsured, cash-paying patients [1]. That price applies across major chains, including CVS, Walgreens, Rite Aid, and independent NJ pharmacies. GoodRx and similar discount aggregators occasionally show prices $20, $40 lower than the list price, but those coupons cannot be combined with insurance copays.

Dapagliflozin belongs to the SGLT2 inhibitor class. The FDA approved it under the Farxiga brand for type 2 diabetes (2014), heart failure with reduced ejection fraction (2020), and chronic kidney disease (2021) [1]. Because it holds three distinct FDA indications backed by large randomized trials, payers treat it as a clinically differentiated agent, which keeps generic entry limited and the price high.

The DAPA-HF trial (N=4,744) demonstrated that dapagliflozin 10 mg once daily reduced the composite of worsening heart failure or cardiovascular death by 26% versus placebo (hazard ratio 0.74; 95% CI 0.65, 0.85; P<0.001) in patients with HFrEF, regardless of diabetes status 2. That data is part of why cardiologists in New Jersey now prescribe Farxiga routinely, driving high demand and limiting the insurer incentive to push a preferred alternative.

For the DAPA-CKD trial (N=4,304), dapagliflozin cut the risk of sustained eGFR decline of 50% or more, end-stage kidney disease, or renal or cardiovascular death by 39% versus placebo 3. The FDA expanded the CKD label on the strength of that single trial.

How NJ FamilyCare (Medicaid) Covers Farxiga

New Jersey Medicaid covers Farxiga with a prior authorization. It does not require step therapy through metformin for the heart failure or CKD indications, which aligns with national guideline updates from the American Diabetes Association (ADA) and the American College of Cardiology 4.

To obtain PA approval under NJ FamilyCare, the prescribing clinician typically documents one of the following: an HbA1c above 7.0% despite at least 90 days of metformin, a confirmed diagnosis of heart failure with ejection fraction 40% or below, or an eGFR between 25 and 75 mL/min/1.73 m² with urine albumin-to-creatinine ratio above 200 mg/g. The NJ FamilyCare preferred drug list (PDL) classifies dapagliflozin as a non-preferred agent in the diabetes category but grants PA more readily for HF and CKD indications where clinical evidence is strongest 5.

Once the PA is approved, the NJ FamilyCare copay for most enrollees is $1 to $3 per prescription. Beneficiaries in the NJ FamilyCare Plan A (full Medicaid) pay no copay at all for approved medications.

The ADA 2024 Standards of Medical Care state: "For patients with type 2 diabetes and established cardiovascular disease or high cardiovascular risk, heart failure, or chronic kidney disease, an SGLT2 inhibitor with proven cardiovascular or kidney benefit is recommended independent of baseline HbA1c" 4. That wording gives prescribers in NJ a direct clinical justification for Farxiga PA requests when standard criteria are borderline.

The AstraZeneca Savings Card: How It Works in New Jersey

Commercially insured New Jersey patients with private, employer-sponsored, or marketplace insurance are eligible for the AstraZeneca Farxiga savings program. Eligible patients may pay as little as $0 per month, with a maximum out-of-pocket of $35 per fill, for up to 12 fills per calendar year [1].

The card is not valid for patients covered by federal programs: Medicare Part D, Medicaid, TRICARE, or the VA. That restriction matters because a large share of New Jersey's older adult population is Medicare-enrolled and therefore excluded.

Enrollment takes three steps: create an account at the AstraZeneca patient support site, receive an enrollment ID, then present that ID (digital or printed) at any NJ pharmacy that processes manufacturer copay cards. Most major NJ chains accept it without prior pharmacy setup. The savings card resets each January 1, so a patient using 12 fills in one calendar year must re-enroll for the next year.

For patients who are uninsured and do not qualify for the savings card, AstraZeneca also runs the AZ&Me Prescription Savings program. Income thresholds for AZ&Me are updated annually; in 2025, individual income below approximately $46,000 per year qualified for free medication 6. NJ patients should check the current threshold directly with AstraZeneca, as the 2026 figure had not been publicly confirmed at the time this article was reviewed.

Which NJ Insurance Plans Cover Farxiga and at What Tier?

Farxiga's formulary placement in New Jersey varies by payer. A review of 2025 and 2026 formulary files for the largest NJ commercial carriers shows the following general pattern 7:

Horizon Blue Cross Blue Shield of New Jersey places Farxiga on Tier 3 (preferred brand) for most commercial plans, with a typical copay of $45, $75 per 30-day supply before the AstraZeneca card is applied. With the savings card, that effective cost drops to $0 to $35.

Aetna NJ and United Healthcare NJ plans tend to place Farxiga on Tier 3 or Tier 4, sometimes requiring a step through another SGLT2 inhibitor (such as empagliflozin or canagliflozin) for the diabetes indication only. The HF and CKD indications typically bypass step-therapy requirements because no interchangeable FDA-approved generic dapagliflozin existed as of mid-2025 7.

AmeriHealth NJ and Oscar Health NJ marketplace plans follow similar tier structures. Patients on high-deductible health plans (HDHPs) pay the negotiated rate until their deductible is met; in 2026, many NJ HDHP negotiated rates for Farxiga fall between $480 and $560 per month before the deductible clears.

Medicare Part D beneficiaries face a different calculation. Under the Inflation Reduction Act changes implemented in 2025, the Part D out-of-pocket cap is $2,000 per year. For NJ seniors using Farxiga at roughly $620/month list price, hitting the $2,000 annual cap takes approximately 3 to 4 months, after which they pay $0 for the rest of the calendar year 8.

Is Compounded Dapagliflozin Legal in New Jersey?

Yes. Compounded dapagliflozin is legal in New Jersey when prepared by a state-licensed 503A compounding pharmacy operating under a valid patient-specific prescription 9. New Jersey's Board of Pharmacy regulates 503A pharmacies under NJAC 13:39-11, which tracks federal 503A standards established in the Drug Quality and Security Act of 2013 10.

The critical legal distinction: dapagliflozin is not on the FDA's 503A bulk drug substances list as a drug that may be compounded regardless of commercial availability. That means a 503A pharmacy in New Jersey may compound dapagliflozin only when the prescribing clinician documents a specific clinical need, typically a documented allergy to an inactive ingredient in the commercial Farxiga tablet, a required dose or concentration not commercially available, or a supply-chain disruption affecting the branded product. Compounding without that documented rationale creates regulatory risk for the pharmacy.

When prepared legally, compounded dapagliflozin oral capsules or solutions at NJ 503A pharmacies typically cost between $50 and $150 per month, depending on dose and formulation, making them a significant cost reduction versus the $620 list price for brand Farxiga.

A decision framework for choosing between brand Farxiga and compounded dapagliflozin in New Jersey:

1. Commercially insured and eligible for the AstraZeneca savings card? Use brand Farxiga. Effective cost: $0, $35/month.
2. NJ FamilyCare enrolled? Use brand Farxiga with a PA. Effective cost: $1, $3/month or $0 for Plan A.
3. Medicare Part D? Use brand Farxiga. After the $2,000 annual cap, cost is $0 for the remainder of the year.
4. Uninsured, income above AZ&Me threshold, and a documented clinical rationale for compounding? A 503A-compounded formulation may reduce monthly cost to $50, $150.
5. Uninsured, income below AZ&Me threshold? Apply to AZ&Me for free branded medication.

The FDA has not placed Farxiga on a shortage list as of July 2025, so the supply-disruption rationale for compounding is weak at present 11. Prescribers in NJ should document the specific clinical rationale carefully before routing a patient to a compounding pharmacy.

Can a New Jersey Telehealth Provider Prescribe Farxiga?

Yes. New Jersey permits telehealth prescribing of Farxiga without a prior in-person visit under the New Jersey Telemedicine and Telehealth Act (P.L. 2017, c. 117) 12. A clinician licensed in New Jersey who conducts a medically appropriate evaluation via synchronous audio-visual telehealth may issue a valid Farxiga prescription.

For HealthRX patients in New Jersey, the clinical evaluation typically includes a review of recent labs (HbA1c, eGFR, urine ACR, basic metabolic panel), current medications, blood pressure, and a discussion of cardiovascular history. The entire intake can be completed remotely. Once the prescription is sent electronically to the patient's preferred NJ pharmacy, the AstraZeneca savings card or NJ FamilyCare coverage applies exactly as it would for an in-person prescription.

Telehealth prescribing of SGLT2 inhibitors has expanded rapidly since 2020. A 2022 analysis published in JAMA Internal Medicine found that telehealth visits for chronic cardiometabolic conditions produced prescribing patterns and 90-day medication adherence rates comparable to in-person visits (adherence rate 78.3% vs. 79.1%; P=0.41) 13. Farxiga's once-daily oral dosing, lack of refrigeration requirement, and self-monitoring simplicity make it well suited for ongoing telehealth management.

Clinical Evidence Supporting Farxiga Across Its Three Indications

New Jersey payers and prescribers cite three landmark trials when making coverage and prescribing decisions for dapagliflozin.

Type 2 Diabetes. The DECLARE-TIMI 58 trial (N=17,160) showed dapagliflozin reduced the composite of hospitalization for heart failure or cardiovascular death by 17% versus placebo (HR 0.83; 95% CI 0.73, 0.95) in adults with type 2 diabetes who had or were at risk for atherosclerotic cardiovascular disease 14. HbA1c reduction was modest (0.42 percentage points at 4 years), but the cardiovascular benefit was independent of glycemic effect.

Heart Failure. DAPA-HF (N=4,744) remains the definitive trial. In patients with HFrEF (ejection fraction 40% or below), dapagliflozin 10 mg once daily reduced the primary composite endpoint by 26% (HR 0.74; P<0.001) over a median follow-up of 18.2 months 2. Roughly 42% of enrolled patients did not have diabetes, which broadened the FDA label beyond diabetic populations.

Chronic Kidney Disease. DAPA-CKD (N=4,304) was stopped early at the first interim analysis because of overwhelming efficacy. Dapagliflozin reduced the primary composite (sustained eGFR decline of 50% or more, end-stage kidney disease, or death from renal or cardiovascular causes) by 39% (HR 0.61; 95% CI 0.51, 0.72; P<0.001) 3. The trial enrolled patients with eGFR 25 to 75 mL/min/1.73 m² and urine ACR 200, 5 to 000 mg/g.

These three trials form the clinical backbone for NJ provider PA justifications and formulary exception requests. Insurers rarely deny coverage when documentation explicitly references these outcomes data.

How to Get the Lowest Possible Farxiga Price in New Jersey

Several cost-reduction pathways exist, and the right one depends on insurance status.

Step 1: Check your formulary. Log in to your NJ insurance portal or call the member services number on your card and ask specifically whether dapagliflozin 10 mg (NDC prefix 00310-0601) is on your formulary and at what tier. Ask whether a formulary exception is possible if it is Tier 4.

Step 2: Apply the AstraZeneca savings card. If you have commercial insurance, register at the AstraZeneca savings site before your next refill. The card is stackable with most commercial copays and reduces out-of-pocket cost to as low as $0/month [1].

Step 3: Use 90-day supply. Many NJ pharmacies and mail-order programs price a 90-day supply at 2.5 times the 30-day copay, effectively giving 7.5 days of medication free. Express Scripts and CVS Caremark both offer this structure for Farxiga on applicable plans.

Step 4: Consider NeedyMeds or the AZ&Me program. Uninsured NJ patients with household incomes below roughly 4x the federal poverty level may qualify for free branded Farxiga through AZ&Me 6. NeedyMeds also maintains an updated database of manufacturer patient assistance programs and can be checked at needymeds.org.

Step 5: Ask your prescriber about formulary exception. The American Heart Association recommends SGLT2 inhibitors as Class I therapy for HFrEF 15. That guideline classification is strong grounds for a formulary exception request if your NJ insurer initially denies coverage.

Safety Profile, Monitoring, and Contraindications Relevant to NJ Patients

Dapagliflozin is contraindicated in patients with an eGFR below 25 mL/min/1.73 m² for the CKD indication and should not be initiated below eGFR 45 mL/min/1.73 m² for the diabetes indication per FDA labeling [1]. It is also contraindicated during pregnancy.

The most common adverse effects are genital mycotic infections (about 8% in women, 3% in men) and urinary tract infections. Diabetic ketoacidosis (DKA) is a rare but serious risk, occurring in approximately 0.1% of patients per year in clinical trials 2. Patients planning surgery or prolonged fasting should hold dapagliflozin 3 to 4 days before the procedure per the Endocrine Society guidance 16.

Volume depletion is a concern in patients on loop diuretics or those with systolic blood pressure below 100 mmHg at baseline. NJ clinicians ordering Farxiga via telehealth should confirm recent BMP and blood pressure values before initiating therapy.

NJ-Specific Pharmacy Access: Where to Fill Farxiga

Farxiga is stocked at virtually all NJ retail pharmacies. Patients in rural or under-served NJ counties (such as Salem, Cape May, and Cumberland) may find that independent pharmacies process the AstraZeneca savings card without the wait times occasionally seen at high-volume urban chains.

Mail-order pharmacy options available to NJ residents include Express Scripts, CVS Caremark, OptumRx, and Amazon Pharmacy. Amazon Pharmacy's transparent pricing model showed a negotiated cash price of approximately $578 per month for Farxiga 10 mg (30 tablets) in mid-2025, slightly below the list price, though the savings card still reduces commercially insured patients' cost more than cash pricing alone 17.

NJ residents without nearby pharmacy access can also use the AstraZeneca home delivery program for patients enrolled in AZ&Me, which ships directly to the patient's home at no charge.

Prior Authorization Strategy for New Jersey Prescribers

PA approval rates for Farxiga in NJ improve substantially when the clinical note contains three specific elements: the qualifying diagnosis with ICD-10 code (E11.65 for type 2 diabetes with hyperglycemia, I50.20 for unspecified systolic HF, or N18.3 for CKD stage 3), a reference to the supporting trial data (DAPA-HF or DAPA-CKD), and the patient's most recent qualifying lab value (ejection fraction report or urine ACR result).

A 2023 retrospective study published in Circulation: Heart Failure found that PA approval rates for SGLT2 inhibitors increased from 61% to 89% when the prescribing note explicitly cited guideline-concordant indications and trial data versus generic clinical language 18. That gap represents a practical opportunity for NJ clinicians.

For HealthRX patients, the clinical team prepopulates PA documentation with the relevant ICD-10 codes, trial citations, and lab references at the time of prescribing, which typically cuts the PA turnaround time from 7 to 10 days to 2, 3 business days.