How to Get Jardiance in Wisconsin: Telehealth, Prescriptions, and Pharmacy Access

What Is Jardiance and Why Doctors Prescribe It in Wisconsin

Jardiance (empagliflozin) is an oral SGLT2 inhibitor approved by the FDA for type 2 diabetes, heart failure, and chronic kidney disease. Beyond blood-sugar lowering, the drug carries landmark cardiovascular and renal outcome data that have made it a first-line agent across multiple specialties. Wisconsin clinicians prescribe it for patients who meet indication criteria under the drug's current FDA label, which covers a broad adult population [1].

Empagliflozin works by blocking sodium-glucose cotransporter 2 in the proximal tubule of the kidney, causing the kidneys to excrete roughly 60, 90 grams of glucose per day in urine [2]. That mechanism also reduces plasma volume and lowers intraglomerular pressure, which explains the drug's benefit on the heart and kidneys independently of its glycemic action.

The EMPA-REG OUTCOME trial (N=7,020) was the first cardiovascular outcomes trial to show that an SGLT2 inhibitor reduced the risk of cardiovascular death by 38% relative to placebo in patients with type 2 diabetes and established cardiovascular disease, published in the New England Journal of Medicine in 2015 [3]. The EMPEROR-Reduced trial (N=3,730) later showed a 25% reduction in the composite of cardiovascular death or heart-failure hospitalization with empagliflozin 10 mg versus placebo in patients with heart failure with reduced ejection fraction (HFrEF), with a hazard ratio of 0.75 (95% CI 0.65, 0.86, P<0.001) [4]. The EMPEROR-Preserved trial extended that finding to heart failure with preserved ejection fraction [5]. The EMPA-KIDNEY trial (N=6,609) then demonstrated a 28% reduction in the risk of kidney disease progression or cardiovascular death in patients with CKD (eGFR 20, 45 or eGFR 45, 90 with urinary albumin-to-creatinine ratio of at least 200), published in the New England Journal of Medicine in 2023 [6].

The American Diabetes Association's 2024 Standards of Care list empagliflozin as a preferred add-on agent for patients with type 2 diabetes and heart failure or CKD regardless of baseline HbA1c [7].

Who Can Prescribe Jardiance in Wisconsin

Any licensed Wisconsin prescriber with DEA or state controlled-substance authority can write a Jardiance prescription. That includes MDs, DOs, nurse practitioners (NPs), and physician assistants (PAs). Jardiance is not a controlled substance, so prescribers do not need a DEA registration specifically for it, only a valid Wisconsin prescribing license.

Wisconsin statute Chapter 441 governs NP prescribing. Certified registered nurse practitioners in Wisconsin may prescribe without a written collaborative agreement as of the state's 2018 independent practice legislation, meaning patients can see an NP-only telehealth practice without a supervising physician co-signing the prescription [8]. PAs prescribe under Chapter 448 and require a practice agreement with a supervising physician, though the supervising physician does not need to be present at the visit.

Telehealth prescribing in Wisconsin is explicitly authorized under Wis. Stat. 448.975 for physicians and equivalent statutes for NPs and PAs. The prescriber must establish a valid patient-provider relationship, which requires a synchronous audio-visual visit (video call) or a prior in-person encounter. Audio-only telehealth does not meet the prescribing standard for Jardiance in Wisconsin because the provider must be able to review transmitted lab values and confirm patient identity [9].

Labs Required Before Starting Jardiance in Wisconsin

Before any Wisconsin prescriber writes a first Jardiance prescription, baseline labs are needed. The core panel is a comprehensive metabolic panel (CMP) to assess eGFR and creatinine, a urinalysis to rule out active urinary tract infection, and an HbA1c if the indication is type 2 diabetes.

Empagliflozin is contraindicated in patients with eGFR <20 mL/min/1.73 m² for the CKD indication and is not expected to provide meaningful glycemic benefit when eGFR <30 mL/min/1.73 m². The FDA-approved prescribing information specifies these thresholds [1]. Patients starting for a heart-failure indication may have an eGFR as low as 20 mL/min/1.73 m² and still receive benefit based on EMPEROR-Reduced data [4].

Wisconsin telehealth platforms typically accept lab results from any CLIA-certified laboratory. Quest Diagnostics and LabCorp both operate patient-service centers across Wisconsin, and most platforms accept results uploaded directly to the patient portal before the video visit. Some platforms order labs on behalf of the patient as part of the intake process, with results reviewed asynchronously before the prescriber joins the live visit.

Repeat monitoring every three to six months typically includes a CMP to track eGFR trajectory and a urine albumin-to-creatinine ratio (uACR) if the indication is CKD [7]. The ACC/AHA 2022 Heart Failure Guidelines also recommend periodic potassium monitoring because co-prescribing with ACE inhibitors or ARBs is common in this population [10].

How to Get a Jardiance Prescription Through Telehealth in Wisconsin

Wisconsin-licensed telehealth providers can prescribe Jardiance in a three-step process: intake and lab review, synchronous video visit, and electronic prescription to a chosen pharmacy.

Step 1: Intake. The patient completes a medical history questionnaire covering current medications, prior diabetes diagnoses, eGFR history, and cardiovascular or kidney disease. Most platforms take 10 to 20 minutes to complete. Lab results uploaded at this stage are reviewed by a clinical team member before the scheduled visit.

Step 2: Video visit. A Wisconsin-licensed prescriber conducts a video consultation, typically 20 to 30 minutes for a new patient. The prescriber confirms the indication, reviews labs, discusses contraindications (active bladder cancer history, recurrent genitourinary infections, type 1 diabetes), and documents a clinical note sufficient to support the prescription and any prior-authorization submission.

Step 3: Electronic prescription. The prescriber sends the prescription electronically to the patient's preferred Wisconsin pharmacy or a mail-order pharmacy licensed in Wisconsin. Most pharmacies fill the prescription within one business day if the drug is in stock. Patients who need prior authorization (see the section below) may wait three to seven additional business days for insurer review.

The HealthRX clinical team has developed a Wisconsin-specific intake checklist that flags prior-authorization triggers before the video visit, reducing average PA approval time by pre-loading required documentation into the insurer's portal the same day the prescription is written.

Wisconsin Medicaid and Prior Authorization for Jardiance

Wisconsin Medicaid (ForwardHealth) covers empagliflozin for type 2 diabetes, heart failure, and CKD with prior authorization. PA is not automatic approval. The prescriber must submit clinical documentation showing the patient meets the indication criteria and that first-line agents have been tried or are contraindicated.

For the type 2 diabetes indication under ForwardHealth, the PA submission typically requires a documented HbA1c of 7.0% or higher, a recent CMP, and evidence that metformin was tried and either failed or is contraindicated. The specific PA criteria are published in the ForwardHealth Online Handbook, which providers access through the Wisconsin Department of Health Services portal [11].

For heart failure, the submission needs an echocardiogram or imaging report confirming reduced or preserved ejection fraction, plus documentation of the patient's NYHA functional class. For CKD, the submission needs eGFR and uACR values consistent with the EMPA-KIDNEY eligibility criteria [6].

Commercial insurers in Wisconsin, including Quartz, Anthem, and WPS Health Solutions, have their own PA criteria, which often mirror ForwardHealth but may require additional step-therapy with a generic SGLT2 inhibitor such as dapagliflozin first. Patients should ask their telehealth or in-person prescriber to check the formulary tier before the visit.

The Boehringer Ingelheim Lilly Diabetes patient-assistance program, Jardiance 360 Support, offers copay cards that reduce out-of-pocket cost to as low as $10 per 30-day supply for commercially insured patients who meet income criteria [12].

Transferring an Existing Jardiance Prescription to Wisconsin

Patients moving to Wisconsin who already take Jardiance can transfer their prescription to a Wisconsin-licensed pharmacy. Under Wisconsin pharmacy law (Wis. Admin. Code Phar 7), a pharmacist at the receiving Wisconsin pharmacy contacts the out-of-state pharmacy to transfer the remaining refills electronically or by phone. The transfer is one-time per prescription, meaning the patient will need a new prescription from a Wisconsin-licensed provider once the transferred supply is exhausted.

Patients on a mail-order supply from an out-of-state pharmacy may continue receiving shipments as long as the dispensing pharmacy is licensed to ship to Wisconsin. All 50-state mail-order pharmacies (CVS Caremark, Express Scripts, and others) maintain Wisconsin dispensing licenses.

If a patient's out-of-state prescriber is not licensed in Wisconsin, the prescriber cannot write new refills for a Wisconsin-resident patient. In that situation, a telehealth visit with a Wisconsin-licensed provider is the fastest path to continuity of care. Same-day telehealth appointments are available through several Wisconsin-licensed platforms.

503A Compounding Pharmacies in Wisconsin

Licensed 503A compounding pharmacies in Wisconsin can compound empagliflozin for patients who have a documented need for a non-commercially available formulation, such as an alternative dose strength or a liquid formulation for patients who cannot swallow tablets. A 503A pharmacy compounds on a per-patient, per-prescription basis under a valid prescription from a licensed Wisconsin prescriber [13].

503A compounding is distinct from FDA-approved Jardiance tablets. Compounded empagliflozin does not carry the same bioequivalence data as the branded product, and the clinical outcomes data from EMPA-REG OUTCOME, EMPEROR-Reduced, and EMPA-KIDNEY were all generated with the branded formulation. Prescribers and patients should weigh that distinction when considering compounded alternatives.

The Wisconsin Pharmacy Examining Board (Wis. Admin. Code Phar 18) governs compounding practice in the state. Patients can verify whether a pharmacy holds an active Wisconsin compounding license through the Wisconsin Department of Safety and Professional Services license lookup tool [14].

Cost, Savings Programs, and Pharmacy Availability in Wisconsin

Brand-name Jardiance 10 mg (30 tablets) has a retail list price of approximately $620, $650 per month without insurance as of mid-2025. With a Jardiance 360 Support copay card, commercially insured patients pay as little as $10 per month [12]. Medicare Part D patients are not eligible for manufacturer copay cards under federal law but may access Boehringer Ingelheim's patient-assistance program if their income qualifies.

Major Wisconsin pharmacy chains, including Walgreens, CVS, Walmart Pharmacy, and Costco Pharmacy, stock Jardiance 10 mg and 25 mg. Regional chains such as Pick 'n Save pharmacy and Festival Foods pharmacy also carry the drug in most Wisconsin metro areas. Patients in rural Wisconsin can use GoodRx or Mark Cuban's Cost Plus Drugs as comparison tools, though Cost Plus Drugs does not currently list empagliflozin because it is still under patent and not available as a generic.

A generic empagliflozin is not expected until at least 2025 to 2026, pending FDA review of ANDA applications and any patent litigation between Boehringer Ingelheim and generic manufacturers. Wisconsin patients without insurance who cannot access manufacturer assistance should ask their prescriber about dapagliflozin (Farxiga), which has similar cardiovascular and renal outcomes data and may be more accessible depending on formulary [15].

Monitoring and Follow-Up After Starting Jardiance in Wisconsin

Starting Jardiance does not end the prescriber relationship. Wisconsin telehealth providers typically schedule a follow-up visit at four to eight weeks after the first prescription to review tolerability, assess for genitourinary infections (the most common adverse effect, occurring in 5 to 8% of women in clinical trials), and confirm eGFR has not declined acutely.

Patients taking Jardiance who undergo surgery or prolonged fasting (greater than 12 hours) should hold the drug at least three to four days before the procedure to reduce the risk of euglycemic diabetic ketoacidosis (euDKA). This recommendation appears in the FDA-approved prescribing information and is especially relevant for Wisconsin patients planning elective procedures [1]. Euglycemic DKA is rare (occurring in well under 1% of patients in RCTs) but requires emergency management when it occurs.

Patients on empagliflozin who develop symptoms of DKA (nausea, vomiting, abdominal pain, malaise) should stop the drug and contact their prescriber immediately, even if blood glucose reads below 250 mg/dL. Standard DKA blood-glucose thresholds do not apply to euDKA.

The ACC/AHA 2022 Heart Failure Guidelines recommend ongoing SGLT2 inhibitor use "indefinitely in patients with HFrEF who tolerate the medication," based on sustained benefit curves observed in EMPEROR-Reduced at 26 months of follow-up [10].