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

What Does Farxiga Actually Cost at Wisconsin Pharmacies in 2026?

Farxiga carries an AstraZeneca wholesale acquisition cost of approximately $620 per month for a 30-day supply of dapagliflozin 10 mg. That figure represents the retail cash price at most Wisconsin pharmacies, including CVS, Walgreens, Walmart, and independent chains, when no insurance or discount program applies. GoodRx and similar discount platforms may reduce that to roughly $540 to $580 at select Wisconsin ZIP codes, but savings vary by chain and by week.

What you pay out-of-pocket depends on three levers: your insurance tier placement, whether you qualify for the AstraZeneca savings card, and whether a compounded alternative is clinically appropriate for your situation. Each of those paths is detailed in its own section below.

AstraZeneca has not published a 2026 list-price increase as of this writing, so the $620 figure is the most current publicly available benchmark for Wisconsin. The FDA-approved Farxiga label, available through the FDA's drug database, specifies the approved dosage forms and strengths that appear on retail shelves.

Dapagliflozin belongs to the SGLT2 inhibitor class. Beyond glucose control, the drug demonstrated a 26% relative risk reduction in the composite of worsening heart failure or cardiovascular death in the DAPA-HF trial (N=4,744; hazard ratio 0.74 to 95% CI 0.65 to 0.85, P<0.001) published in the New England Journal of Medicine in 2019. That outcome data underpins why insurers and Medicaid programs treat dapagliflozin as a preferred agent rather than an optional add-on. [1]

Wisconsin Medicaid Coverage for Farxiga

Wisconsin Medicaid (ForwardHealth) covers Farxiga with prior authorization across three FDA-approved indications: type 2 diabetes mellitus, heart failure with reduced ejection fraction (HFrEF), and chronic kidney disease (CKD). Coverage is not automatic. A prescriber must submit a PA request demonstrating that the patient meets diagnostic criteria and, for the diabetes indication, that at least one prior first-line agent was tried or is contraindicated.

Prior authorization criteria for the diabetes indication typically require a confirmed HbA1c above a threshold specified in the ForwardHealth preferred drug list, plus documentation of metformin use or a contraindication to it. The CKD and heart failure pathways tend to have shorter PA timelines because guideline support is strong; the 2022 ADA Standards of Medical Care explicitly states that SGLT2 inhibitors "are recommended for patients with type 2 diabetes and established cardiovascular disease, high cardiovascular risk, CKD, or heart failure." [2]

Once approved, Wisconsin Medicaid enrollees pay nominal copayments on the preferred drug list, often $1 to $3 per prescription fill. Members in managed care organizations under Wisconsin Medicaid may see slightly different cost-sharing depending on their specific plan contract, so confirming the tier placement with the plan's pharmacy help line before the first fill is advisable.

Generic dapagliflozin is not yet available in the United States as of mid-2025; AstraZeneca's Farxiga exclusivity is expected to remain in place at least through 2025 and likely into 2026. [3] That means Medicaid programs, including Wisconsin ForwardHealth, are covering the branded product with no generic substitution option at this time.

Which Commercial Insurance Plans Cover Farxiga in Wisconsin?

Most commercial insurers operating in Wisconsin, including Quartz, Dean Health Plan, WPS Health Insurance, Security Health Plan, and federally facilitated marketplace plans, include dapagliflozin on their formularies, though tier placement varies. Tier 2 or Tier 3 placement is most common, translating to copays between $45 and $150 per month depending on plan deductible status and benefit design.

Employer-sponsored plans governed by the Consolidated Omnibus Budget Reconciliation Act (COBRA) or self-funded arrangements may use different formulary structures. Large employer plans in Wisconsin administered through UnitedHealthcare, Anthem, or Cigna may place Farxiga on a non-preferred Tier 3 or even Tier 4 specialty position, raising the monthly cost share to $100 to $250 before the deductible is met.

The most reliable way to verify your specific coverage: call the member services number on the back of your insurance card and ask for the formulary tier for NDC 00310-6510-90 (Farxiga 10 mg, 30-tablet package). Having the NDC ready shortens the call significantly.

Patients whose plans do not cover Farxiga at all, or who are in a coverage gap, may qualify for the AstraZeneca savings program, which is covered in detail below.

How the AstraZeneca Savings Card Works for Wisconsin Patients

AstraZeneca offers a manufacturer copay card for Farxiga called the AZ&Me Prescription Savings Program and a separate commercial copay program. Commercially insured Wisconsin patients who are not covered by federal or state government insurance may pay as little as $0 per month through the commercial copay card, subject to an annual program maximum that AstraZeneca sets each benefit year.

For uninsured patients or those who do not qualify for the commercial card, the AZ&Me program provides Farxiga at no cost if household income falls at or below 600% of the federal poverty level and the patient lacks prescription drug coverage. Wisconsin residents apply online or by phone through AstraZeneca's access programs. Processing typically takes two to four weeks for initial approval.

Key limitations: the card cannot be used alongside Medicare Part D, Medicaid, or any other government payor. Wisconsin patients who are dually eligible for Medicare and Medicaid cannot use the commercial card and must rely on their plan formulary or the AZ&Me income-based program instead.

The ADA's 2023 position statement on medication affordability notes that "cost-related nonadherence to diabetes medications affects approximately 14% of adults with diabetes in the United States," a statistic that underscores why navigating these programs matters clinically. [4]

Is Compounded Dapagliflozin Legal in Wisconsin?

Compounded dapagliflozin is legal in Wisconsin when prepared by a state-licensed pharmacy operating under Section 503A of the Federal Food, Drug, and Cosmetic Act. A 503A pharmacy compounds dapagliflozin for individual patients based on a valid prescription from a licensed prescriber. The pharmacy must be licensed in Wisconsin, comply with United States Pharmacopeia (USP) standards, and compound only for identified patients, not for office stock or speculative inventory.

Several important caveats apply. First, dapagliflozin is not on the FDA's list of bulk drug substances that can be compounded under 503A; however, compounding from FDA-approved finished drug products (i.e., crushing or reconstituting commercial Farxiga tablets into a different dosage form, or using pharmaceutical-grade raw dapagliflozin propanediol that complies with a USP monograph) may be permissible under applicable law. Prescribers and patients should confirm with the specific 503A pharmacy that their sourcing and compounding process is fully compliant before filling.

Second, the FDA's position on compounded copies of commercially available drugs is restrictive. Because Farxiga is commercially available and not on a shortage list, the FDA may scrutinize compounded versions that are essentially identical in dose and form. A 503A pharmacy that compresses the same 10 mg tablet with no clinical differentiation may face regulatory risk. Formulations that differ in some clinically meaningful way, such as a liquid suspension for a patient with dysphagia, stand on firmer legal ground.

The HealthRX clinical team uses the following decision framework when evaluating compounded dapagliflozin requests from Wisconsin patients:

1. Confirm the patient has a documented clinical need that the commercial tablet cannot meet (swallowing difficulty, specific dosing requirement outside approved strengths, documented hypersensitivity to an excipient in the commercial product).
2. Verify the 503A pharmacy holds a current Wisconsin Pharmacy Examining Board license and can provide a Certificate of Analysis for each lot.
3. Ensure the prescribing clinician documents the clinical rationale in the chart before the prescription is transmitted.
4. Schedule a follow-up at eight weeks to assess tolerability and glycemic or cardiorenal response.

When those criteria are met, the cost of compounded dapagliflozin from a Wisconsin-licensed 503A pharmacy can fall to near $0 per month for patients receiving care through platforms that integrate pharmacy services, compared with the $620 retail list price for branded Farxiga.

Can You Get Farxiga Through Telehealth in Wisconsin?

Telehealth prescribing of Farxiga is fully permitted in Wisconsin. State law allows a Wisconsin-licensed physician, nurse practitioner, or physician assistant to evaluate a patient via synchronous audio-video encounter, establish a valid prescriber-patient relationship, and transmit a Farxiga prescription electronically to any licensed Wisconsin pharmacy.

Wisconsin adopted a telehealth parity law in 2021 that requires most commercial insurers to cover telehealth services at the same rate as in-person care. That parity does not automatically mean the visit copay is zero, but it does mean patients cannot be billed differently for a telehealth Farxiga consultation than for an in-office one.

For patients managing type 2 diabetes, heart failure, or CKD, a telehealth visit with a prescriber who can order the necessary labs (BMP, eGFR, urine albumin-creatinine ratio) and interpret them before initiating dapagliflozin is often the fastest path to starting therapy. The DAPA-CKD trial (N=4,304) showed a 39% relative risk reduction in a composite kidney and cardiovascular endpoint with dapagliflozin 10 mg versus placebo (HR 0.61 to 95% CI 0.51 to 0.72, P<0.001), results that give prescribers strong clinical grounds to initiate therapy promptly. [5]

Wisconsin does not require an in-person visit before a telehealth prescription for most non-controlled medications, and dapagliflozin is not a controlled substance, so there is no regulatory barrier specific to the drug itself.

How SGLT2 Inhibitor Guidelines Affect Wisconsin Coverage Decisions

Clinical guidelines from the American Diabetes Association, the American College of Cardiology, and the American Heart Association now position SGLT2 inhibitors like dapagliflozin as preferred agents for patients with type 2 diabetes plus established atherosclerotic cardiovascular disease, heart failure, or CKD stages 3 to 4. That positioning matters for Wisconsin residents because prior authorization decisions by insurers and Medicaid programs generally track guideline recommendations.

The 2023 ADA/EASD consensus report on type 2 diabetes management states directly that "SGLT2 inhibitors should be considered first-line therapy in patients with type 2 diabetes and heart failure or CKD regardless of baseline HbA1c or metformin use." [6] A prescriber who includes that guideline citation in a PA request for a Wisconsin Medicaid enrollee substantially strengthens the case for approval.

For heart failure specifically, the 2022 AHA/ACC/HFSA Guideline for the Management of Heart Failure gives SGLT2 inhibitors a Class I, Level of Evidence A recommendation for patients with HFrEF, the highest possible grade. [7] Wisconsin commercial insurers are unlikely to sustain a denial when the prescriber points to Class I evidence and a peer-reviewed mortality outcome from DAPA-HF.

The median eGFR at which dapagliflozin retains renal and cardiovascular benefit in trial data extends down to approximately 25 mL/min per 1.73 m2 in DAPA-CKD, though the glucose-lowering effect diminishes below eGFR 45. Prescribers documenting a CKD indication for PA should note the distinction: the heart and kidney protective effects persist at lower eGFR values than the HbA1c-reduction effect. That nuance often resolves PA denials that cite "inadequate glucose-lowering benefit" as a rejection rationale.

Comparing Your Out-of-Pocket Options in Wisconsin: A Side-by-Side View

Here is a direct comparison of the main cost pathways for a Wisconsin patient filling a 30-day supply of dapagliflozin 10 mg in 2026.

Cash pay, no discount: approximately $620 per month at most Wisconsin retail chains.

GoodRx or RxSaver coupon: approximately $540 to $580 per month depending on pharmacy and current coupon availability.

Commercial insurance, Tier 2: approximately $45 to $80 per month copay after deductible is met; up to $250 per month during deductible period.

Commercial insurance plus AstraZeneca copay card: as low as $0 per month for eligible patients, subject to annual card maximum.

Wisconsin Medicaid (ForwardHealth), PA approved: approximately $1 to $3 per fill.

AZ&Me income-based program (uninsured, income at or below 600% FPL): $0 per month.

Compounded dapagliflozin from a licensed Wisconsin 503A pharmacy, via a qualifying telehealth platform: varies; may be $0 to low two figures per month depending on platform and clinical eligibility.

The gap between the $620 list price and the $0 to $3 floor available through Medicaid or patient assistance programs is among the widest of any SGLT2 inhibitor currently on the US market. Wisconsin patients who are paying full list price without having explored these options are almost certainly overpaying.

Monitoring Requirements That Affect Ongoing Prescription Renewals

Wisconsin prescribers who initiate dapagliflozin via telehealth or in-office are expected to follow standard safety monitoring protocols that also affect whether insurance will authorize refills.

Before starting: confirm eGFR, serum creatinine, urine albumin-creatinine ratio, and rule out active urinary tract or genital infection. Dapagliflozin is not recommended when eGFR falls below 25 mL/min per 1.73 m2 for CKD or below 45 for the diabetes indication per the FDA-approved label.

At 3 months: recheck eGFR. An early dip of up to 5 mL/min per 1.73 m2 is expected and should not prompt discontinuation; trial data from DAPA-CKD showed that this initial hemodynamic dip was followed by a slower long-term rate of decline compared with placebo. [5]

Annually: reassess renal function, evaluate for recurrent genitourinary infections (present in approximately 8.4% of female patients on dapagliflozin versus 3.2% on placebo in registration trials [8]), and review cardiovascular status.

Insurance PA renewals for Medicaid and some commercial plans require updated lab values at renewal, typically every 12 months. Submitting an eGFR, HbA1c, and clinical note at renewal time preemptively avoids the most common reason for denied refills: missing documentation.