How Much Does Farxiga (Dapagliflozin) Cost in New York in 2026?

Farxiga Retail Pricing Across New York in 2026

The sticker price for a 30-day supply of Farxiga 10 mg in New York hovers around $620, consistent with AstraZeneca's national list price. That figure reflects cash-pay cost at retail chains and independent pharmacies statewide, from Manhattan to Buffalo. Without insurance or a discount program, few patients pay this amount out of pocket for long.

Why the List Price Rarely Reflects What You Actually Pay

Pharmacy benefit managers (PBMs) negotiate rebates with AstraZeneca that lower the net cost for insurers, and those savings typically pass through to patients as lower copays or coinsurance. A 2023 IQVIA analysis found that net prices for branded SGLT2 inhibitors averaged 40% to 60% below list after rebates [1]. The gap between list and net price is wide, which means the $620 figure overstates what most insured New Yorkers spend.

Cash-Pay Strategies for Uninsured Patients

If you lack prescription coverage entirely, a few approaches can cut costs. AstraZeneca's patient assistance program provides Farxiga at no cost to qualifying individuals with household income at or below 300% of the federal poverty level. GoodRx and RxSaver discount cards sometimes bring the retail price down to the $500 to $560 range at select New York pharmacies, though savings vary by location and month.

New York Medicaid Coverage for Farxiga

New York Medicaid lists Farxiga on its preferred drug list for type 2 diabetes, heart failure with reduced ejection fraction, and chronic kidney disease. Coverage requires prior authorization (PA). The prescriber must document that the patient meets specific clinical criteria, typically a confirmed diagnosis plus evidence that first-line therapies (metformin for diabetes, standard heart-failure regimens for HFrEF) have been tried or are contraindicated.

How the Prior Authorization Process Works

The PA request goes through the patient's Medicaid managed care plan. Most New York Medicaid managed care organizations (MCOs), including Healthfirst, Fidelis Care, and Amerigroup, process PA decisions within 24 to 72 hours. If denied, prescribers can file a fair hearing appeal through the New York State Department of Health. Approval periods vary by MCO but commonly last 12 months before renewal.

Medicaid and the DAPA-HF Evidence Base

Medicaid plans in New York increasingly approve Farxiga for heart failure following the DAPA-HF trial (N=4,744), which demonstrated that dapagliflozin 10 mg reduced the composite of worsening heart failure or cardiovascular death by 26% compared with placebo (hazard ratio 0.74; 95% CI, 0.65 to 0.85; P<0.001) over a median follow-up of 18.2 months [2]. The American College of Cardiology and the American Heart Association now give SGLT2 inhibitors a Class I recommendation for HFrEF, which strengthens PA approval odds [3].

Insurance Coverage Beyond Medicaid

Most major commercial insurers operating in New York cover Farxiga, though tier placement and cost-sharing differ. Plans from UnitedHealthcare, Aetna, Cigna, Empire BlueCross BlueShield, and Oscar Health generally place Farxiga on a preferred brand tier (Tier 2 or Tier 3), with copays between $30 and $75 per month before any manufacturer offset.

Employer-Sponsored Plans

Large employer plans in New York tend to cover SGLT2 inhibitors with step therapy. A common requirement: the patient must have tried metformin (and sometimes a sulfonylurea) before the plan approves dapagliflozin for type 2 diabetes. For heart failure and CKD indications, step therapy requirements are less common because SGLT2 inhibitors occupy a distinct therapeutic role that other oral agents do not fill.

Medicare Part D

Medicare Part D plans in New York cover Farxiga, but the out-of-pocket burden can be steep during the coverage gap. Under the Inflation Reduction Act's $2,000 annual out-of-pocket cap (effective since 2025), Medicare beneficiaries now face a hard ceiling on total yearly drug spending [4]. For a patient whose only high-cost medication is Farxiga, the $2,000 cap may be reached within four to five months, after which the plan covers the remaining fills at no additional cost.

How to Check Your Specific Plan

Call the number on your insurance card or log in to your plan's formulary lookup tool. Ask three questions: Is dapagliflozin 10 mg covered? What tier? Is prior authorization or step therapy required? Getting these answers before your prescriber sends the script to the pharmacy avoids surprise costs at the counter.

The AstraZeneca Savings Card

AstraZeneca offers a manufacturer copay card that reduces the out-of-pocket cost of Farxiga to $0 per month for eligible commercially insured patients. The card covers up to $175 per 30-day fill, which is enough to eliminate most copays. Patients with government insurance (Medicare, Medicaid, Tricare, VA) do not qualify for the savings card under federal anti-kickback rules.

Enrollment and Eligibility

Enrollment takes about two minutes on the AstraZeneca website or through the prescriber's office. Eligibility criteria: you must have commercial or private insurance, be a U.S. Resident, and be 18 years or older. The card activates at the pharmacy and applies automatically to each fill. Most New York pharmacies accept it without issue.

Annual Limits

The savings card has a maximum annual benefit (typically $1,800 to $2,100 per calendar year, though AstraZeneca adjusts this periodically). A patient filling Farxiga 12 times per year with a $50 copay would use $600 of that annual cap. Only patients with very high coinsurance percentages risk exhausting the benefit before year-end.

Compounded Dapagliflozin in New York

Licensed 503A compounding pharmacies in New York can legally prepare dapagliflozin formulations under a valid patient-specific prescription. New York State Board of Pharmacy regulations align with federal 503A rules under the Drug Quality and Security Act (DQSA) of 2013, which permit compounding when a prescriber determines that a commercially available product does not meet a patient's medical needs [5].

When Compounding Makes Clinical Sense

Compounded dapagliflozin may be appropriate for patients who need a non-standard dose, an alternative dosage form (liquid suspension for patients with swallowing difficulties), or removal of a specific inactive ingredient that triggers an allergy. It is not intended as a generic substitute purely for cost savings. The FDA and New York State Board of Pharmacy both maintain that 503A compounding must be based on an individualized medical need, not bulk production for general distribution.

Cost Considerations

Pricing from 503A compounding pharmacies varies widely. Some New York compounders price dapagliflozin preparations below the brand cost, while others charge comparable rates depending on formulation complexity. Always confirm that the pharmacy holds a current New York State license and complies with United States Pharmacopeia (USP) chapters 795 and 797 for non-sterile and sterile compounding, respectively.

State Oversight

The New York State Education Department's Office of the Professions regulates pharmacy practice in the state. Compounding pharmacies face inspections, reporting requirements, and disciplinary action for non-compliance. This regulatory framework provides a layer of quality assurance that patients should verify before filling a compounded prescription.

Telehealth Prescribing of Farxiga in New York

New York permits telehealth prescribing of Farxiga. Physicians, nurse practitioners, and physician assistants licensed in New York can evaluate a patient via synchronous audio-video visit and issue a dapagliflozin prescription electronically to any New York pharmacy. The state's telehealth parity law (New York Insurance Law § 3217-h) requires commercial insurers to cover telehealth visits at the same rate as in-person encounters [6].

Practical Steps for a Telehealth Prescription

Schedule a visit with a New York-licensed prescriber through a telehealth platform or your existing provider's virtual care portal. Have recent lab work available: a basic metabolic panel (BMP), hemoglobin A1c (for diabetes), estimated glomerular filtration rate (eGFR), and brain natriuretic peptide (BNP) or NT-proBNP (for heart failure). The prescriber will review your labs, confirm the indication, and send the prescription electronically.

Clinical Context: Why Dapagliflozin Costs What It Does

Farxiga's pricing reflects AstraZeneca's investment in a clinical trial program spanning multiple indications. The DAPA-HF trial showed a 26% relative risk reduction in the composite of cardiovascular death or worsening heart failure [2]. The DAPA-CKD trial (N=4,304) found that dapagliflozin reduced the composite of sustained eGFR decline of 50% or more, end-stage kidney disease, or renal or cardiovascular death by 39% compared with placebo (HR 0.61; 95% CI, 0.51 to 0.72; P<0.001) [7].

Three Approved Indications Under One Molecule

The FDA has approved dapagliflozin for type 2 diabetes (2014), heart failure with reduced ejection fraction (2020), and chronic kidney disease (2021) [8]. Each approval required a dedicated phase III program. Dr. John McMurray, principal investigator of DAPA-HF, noted: "SGLT2 inhibitors have changed the standard of care for heart failure regardless of diabetes status" [2]. This breadth of indication contributes to AstraZeneca's pricing strategy and to insurers' willingness to cover the drug across multiple disease states.

Cost-Effectiveness Data

A 2021 analysis published in JAMA Network Open estimated that dapagliflozin for CKD had an incremental cost-effectiveness ratio (ICER) of approximately $42,000 per quality-adjusted life year (QALY) gained, well below the commonly cited $100,000-per-QALY willingness-to-pay threshold in the United States [9]. For heart failure, separate modeling studies have reported ICERs in the $50,000 to $80,000 range depending on the patient population and time horizon [10].

How to Get the Lowest Price in New York

A step-by-step approach can minimize your out-of-pocket spending on Farxiga in New York.

Step 1: Confirm Insurance Coverage

Check your formulary. If Farxiga is covered, note the tier and any PA or step therapy requirements. Ask your prescriber to submit the PA proactively.

Step 2: Apply the AstraZeneca Savings Card

If you have commercial insurance, activate the savings card before your first fill. It stacks on top of your plan's negotiated price, often bringing the copay to $0.

Step 3: Compare Pharmacy Prices

Prices can differ by $20 to $80 between pharmacies in the same New York ZIP code. Use a price-comparison tool or call two to three local pharmacies to check the cash price and whether they accept the savings card.

Step 4: Explore Patient Assistance if Uninsured

If you have no insurance and your income qualifies, apply to AstraZeneca's patient assistance program (AZ&Me). Processing takes two to four weeks, and approved patients receive Farxiga at no cost for up to 12 months, renewable annually.

Step 5: Ask About Compounding Only if Clinically Indicated

If you have a documented medical need for a non-standard formulation, ask your prescriber whether a 503A-compounded preparation of dapagliflozin is appropriate. Do not pursue compounding solely to avoid brand pricing unless a clinical rationale exists.

Monitoring Costs Beyond the Drug Itself

Dapagliflozin requires periodic lab monitoring that adds to total treatment cost. The FDA labeling recommends checking renal function (serum creatinine and eGFR) before initiation and periodically thereafter [8]. For patients with heart failure, BNP or NT-proBNP levels guide treatment response. A BMP at a New York commercial lab typically costs $15 to $40 with insurance and $50 to $100 at cash-pay rates.

Genital Mycotic Infections: A Manageable but Real Cost

SGLT2 inhibitors increase urinary glucose excretion, raising the risk of genital yeast infections. In the DECLARE-TIMI 58 trial (N=17,160), genital infections occurred in 0.9% of dapagliflozin-treated patients versus 0.1% in the placebo group [11]. Over-the-counter antifungal treatment costs $8 to $15 per episode at most New York pharmacies.

Dapagliflozin 10 mg once daily costs $620 per month at list price in New York, but the real out-of-pocket figure for most patients falls between $0 and $75 depending on insurance status and savings-card eligibility.