How Much Does Farxiga Cost in Ohio in 2026?

Ohio Retail Cash Price for Farxiga

The average cash price for a 30-day supply of brand Farxiga 10 mg across Ohio retail pharmacies in 2026 is $620. This figure reflects the AstraZeneca manufacturer list price, which has remained stable since late 2024.

Prices vary modestly between pharmacy chains. CVS, Walgreens, and Kroger locations in Columbus, Cleveland, and Cincinnati typically quote within $10 of this figure for uninsured patients. Independent pharmacies may offer marginally lower prices but rarely below $580 per month. The price difference between metro and rural Ohio pharmacies is negligible for this medication because wholesale acquisition cost sets the floor.

Dapagliflozin remains under patent protection with no FDA-approved generic available in the United States as of May 2026. AstraZeneca's Farxiga prescribing information lists the 5 mg and 10 mg tablet strengths, with the 10 mg dose being standard for all three approved indications [1]. Without insurance or discount programs, Ohio residents face one of the higher monthly costs among SGLT2 inhibitors. Jardiance (empagliflozin) carries a comparable list price of approximately $630 per month.

Ohio Medicaid Coverage for Dapagliflozin

Ohio Medicaid does not include Farxiga on its preferred drug list for type 2 diabetes management alone. This matters for the roughly 3.4 million Ohioans enrolled in Medicaid managed care plans.

Coverage becomes possible through prior authorization when the prescribing indication is heart failure with reduced ejection fraction (HFrEF) or chronic kidney disease (CKD). The clinical basis for this coverage distinction rests on the DAPA-HF trial, which demonstrated a 26% relative risk reduction in the composite of worsening heart failure or cardiovascular death (HR 0.74; 95% CI 0.65-0.85; P<0.001) with dapagliflozin 10 mg versus placebo, regardless of diabetes status [2]. The DAPA-CKD trial similarly showed a 39% reduction in the composite kidney endpoint [3].

Ohio Medicaid managed care organizations (MCOs), including CareSource, Molina, Buckeye Health Plan, and UnitedHealthcare Community Plan, each maintain their own prior authorization criteria. Most require documentation of:

• NYHA Class II-IV heart failure with LVEF ≤40%, or
• eGFR between 25-75 mL/min/1.73m² with albuminuria, and
• Trial or contraindication to at least one preferred SGLT2 inhibitor (typically empagliflozin)

Approval timelines run 5-10 business days for standard requests. Urgent authorization can be processed within 24-72 hours when clinical documentation supports immediate need.

Compounded Dapagliflozin in Ohio

Compounded dapagliflozin is legal in Ohio through licensed 503A compounding pharmacies. This route offers a substantially lower price point for patients paying out of pocket.

Ohio follows federal law under the Drug Quality and Security Act (2013), which permits 503A pharmacies to compound medications based on individual patient prescriptions. A valid prescription from a licensed prescriber is required. The compounded product is not FDA-approved and does not carry the same bioequivalence testing as brand Farxiga, but 503A pharmacies must comply with United States Pharmacopeia (USP) standards for potency, purity, and beyond-use dating.

Several Ohio-based 503A pharmacies and national compounding pharmacies shipping to Ohio offer dapagliflozin capsules at prices ranging from $45 to $120 per month. The variation depends on whether the pharmacy sources raw dapagliflozin API domestically or internationally, and whether they bundle prescriber consultations into the price.

Patients considering compounded dapagliflozin should verify that the pharmacy holds a valid Ohio Board of Pharmacy license and operates under current 503A registration. The Ohio Board of Pharmacy maintains a public database for license verification. Dr. Michael Schlosser, PharmD, a compounding pharmacy specialist in Columbus, has noted: "Patients switching from brand to compounded SGLT2 inhibitors should have their prescriber monitor fasting glucose and A1c at 4-6 weeks to confirm therapeutic equivalence."

Insurance Coverage Beyond Medicaid

Commercial insurance plans in Ohio generally cover Farxiga, though tier placement and copay amounts vary considerably across carriers.

Most employer-sponsored plans through Anthem Blue Cross Blue Shield, Medical Mutual of Ohio, and UnitedHealthcare place Farxiga on Tier 3 (preferred brand) or Tier 4 (non-preferred brand) formularies. Tier 3 copays typically range from $35 to $75 per month. Tier 4 placement pushes copays to $75-$150 or requires coinsurance of 25-40% after deductible.

The 2022 ADA Standards of Medical Care recommend SGLT2 inhibitors as second-line therapy for patients with type 2 diabetes and established cardiovascular disease or CKD, independent of A1c [4]. This guideline positioning strengthens prior authorization appeals when plans initially deny coverage.

Ohio marketplace plans (ACA exchange) through Healthcare.gov show mixed coverage. Silver and Gold plans from Ambetter, Molina Marketplace, and Oscar Health include Farxiga with prior authorization for the HF and CKD indications. Bronze plans often exclude it entirely or apply full coinsurance.

For Medicare Part D enrollees in Ohio, Farxiga coverage depends on the specific plan. The Inflation Reduction Act's $2,000 annual out-of-pocket cap (effective 2025) means that even patients on plans with high coinsurance will not exceed $2,000 total for all Part D drugs in a calendar year. This significantly reduces the effective annual cost for Medicare beneficiaries taking Farxiga.

AstraZeneca Savings Card and Discount Programs

The AstraZeneca Farxiga Savings Card is the single most effective cost-reduction tool for commercially insured Ohio patients. Eligible patients pay as little as $0 per 30-day fill.

Eligibility requires commercial insurance (not Medicare, Medicaid, or other government programs), a valid prescription, and U.S. residency. The card covers up to $250 per fill in copay assistance. For a patient with a $75 Tier 3 copay, the card reduces out-of-pocket cost to $0. For patients with higher coinsurance amounts, the card covers up to its cap, leaving the patient responsible for any remainder above $250.

Additional savings pathways for Ohio patients include:

GoodRx and RxSaver coupons. These aggregator platforms show Ohio pharmacy prices ranging from $490-$560 per month. Not a dramatic savings over list price, but useful for uninsured patients who cannot access compounded alternatives.

AstraZeneca Patient Assistance Program (AZ&Me). For uninsured patients earning below 400% of the federal poverty level (approximately $62,400 for a single individual in 2026), AZ&Me provides brand Farxiga at no cost. Application requires income documentation and prescriber signature. Approval typically takes 2-4 weeks.

340B pharmacies. Ohio patients receiving care at federally qualified health centers (FQHCs) or 340B-eligible hospitals may access Farxiga at the 340B discounted price. Ohio has over 200 340B-covered entities, concentrated in urban areas but present in rural counties as well.

Telehealth Prescribing in Ohio

Ohio permits telehealth prescribing of Farxiga statewide. No in-person visit is required for initial or ongoing prescriptions.

The Ohio State Medical Board allows synchronous audio-video telemedicine encounters to establish a patient-prescriber relationship sufficient for prescribing prescription medications, including SGLT2 inhibitors. This policy, codified under Ohio Revised Code §4731.296, was made permanent following the COVID-era temporary allowances.

Telehealth platforms operating in Ohio that prescribe dapagliflozin include HealthRX, Ro, Hims, and several endocrinology-focused virtual practices. A typical telehealth pathway involves completing a medical intake, providing recent lab results (A1c, basic metabolic panel, eGFR), and a video consultation with an Ohio-licensed prescriber.

For patients combining telehealth with compounded dapagliflozin, the prescriber writes the prescription directly to the 503A compounding pharmacy. Total monthly cost through this pathway (consultation fee plus compounded medication) can run $80-$180, compared to $620 for brand at retail.

Clinical Value Supporting the Cost

The cost of Farxiga must be weighed against its demonstrated clinical benefits across three distinct indications, each supported by large randomized trials.

In DAPA-HF (N=4,744), dapagliflozin 10 mg reduced the primary composite endpoint of cardiovascular death or worsening heart failure by 26% versus placebo over a median 18.2 months of follow-up [2]. The number needed to treat (NNT) was 21 to prevent one primary endpoint event. Benefits appeared within 28 days of treatment initiation and were consistent regardless of baseline diabetes status.

In DAPA-CKD (N=4,304), dapagliflozin reduced the composite of sustained ≥50% eGFR decline, end-stage kidney disease, or renal/cardiovascular death by 39% (HR 0.61; 95% CI 0.51-0.72; P<0.001) over median 2.4 years [3]. The trial was stopped early for overwhelming efficacy. As noted in the Kidney Disease: Improving Global Outcomes (KDIGO) 2024 guidelines: "SGLT2 inhibitors are recommended for patients with CKD and eGFR ≥20 mL/min/1.73m², with or without diabetes" [5].

For type 2 diabetes, the DECLARE-TIMI 58 trial (N=17,160) demonstrated cardiovascular safety and a 17% relative reduction in hospitalization for heart failure over median 4.2 years [6]. A1c reduction averaged 0.4% versus placebo at 4 years. The cardiovascular benefit makes dapagliflozin cost-effective relative to older diabetes drugs that lack organ-protective effects.

How to Get the Lowest Price in Ohio

The optimal cost strategy depends on insurance status. Here is a decision framework for Ohio residents:

Commercially insured: Apply for the AstraZeneca Savings Card first. If your plan covers Farxiga at any tier, the card likely reduces your copay to $0. Confirm with your plan that the savings card value applies toward your deductible (some plans count it, others do not under accumulator adjustment programs).

Ohio Medicaid enrolled: Request prior authorization through the HF or CKD indication if applicable. If prescribed for T2D only, ask your prescriber about therapeutic alternatives on the preferred list (empagliflozin is preferred on most Ohio MCO formularies) or explore the compounded route.

Uninsured, income below 400% FPL: Apply for AZ&Me patient assistance for free brand medication.

Uninsured, income above 400% FPL: Compounded dapagliflozin through a licensed 503A pharmacy offers the lowest monthly cost at $45-$120.

Medicare Part D: Choose a plan during open enrollment that covers Farxiga at Tier 3 or lower. The $2,000 annual OOP cap limits total exposure regardless of tier placement. At a 25% coinsurance rate on $620/month, you would hit the cap by approximately month 13, effectively paying $154/month averaged across the year.