Jardiance Cost in New Hampshire 2026

What Is the Retail Price of Jardiance in New Hampshire?

The retail cash price for Jardiance in New Hampshire is approximately $680 per month in 2026, consistent with the national manufacturer list price set by Boehringer Ingelheim and Eli Lilly. Without insurance or a savings program, a 30-day supply of either the 10 mg or 25 mg tablet costs the same at most chain pharmacies across the state, including CVS, Walgreens, and Hannaford.

Prices vary by pharmacy by $20 to $40 in either direction. The FDA-approved label for empagliflozin identifies two commercially available strengths: 10 mg and 25 mg film-coated tablets taken once daily in the morning, with or without food. [1] Both strengths carry the same list price per 30-tablet pack. Patients starting at 10 mg who later titrate to 25 mg will not pay more at the counter, but the prescription must reflect the new strength.

Retail pricing data aggregators such as GoodRx and RxSaver regularly publish coupon prices in the $480 to $560 range at selected NH pharmacies, representing savings of 15 to 30 percent off the list price. These coupons cannot be combined with insurance benefits but can be used by any cash-paying patient regardless of income. The Boehringer Ingelheim / Lilly savings card is a separate program with potentially larger reductions for commercially insured patients (covered below).

The absence of an FDA-approved generic empagliflozin means there is no automatic cheaper substitute a pharmacist can dispense. The Hatch-Waxman exclusivity period and ongoing patent protections for Jardiance extend into the late 2020s, keeping brand-only pricing in place at retail. [2]

Does New Hampshire Medicaid Cover Jardiance?

New Hampshire Medicaid (NH Medicaid) does not cover Jardiance for the majority of its beneficiaries. The NH Medicaid preferred drug list places empagliflozin in a non-preferred or non-covered tier, meaning standard prior authorization will generally be denied without compelling clinical justification documented in the medical record.

This coverage gap is clinically significant. The EMPA-REG OUTCOME trial (N=7,020) demonstrated that empagliflozin reduced the composite of cardiovascular death, nonfatal myocardial infarction, or nonfatal stroke by 14% relative to placebo (hazard ratio 0.86 to 95% CI 0.74 to 0.99, P<0.001 for non-inferiority; P=0.04 for superiority) in adults with type 2 diabetes and established cardiovascular disease. [3] Cardiovascular death was reduced by 38% in absolute relative risk terms.

Despite this evidence, Medicaid formularies in many states, including NH, have been slow to grant broad preferred-tier status to SGLT2 inhibitors. Prescribers appealing a denial should reference the 2023 ACC/AHA heart failure guideline, which gives empagliflozin a Class I, Level A recommendation for patients with heart failure with reduced ejection fraction and a Class IIa recommendation for those with preserved ejection fraction. [4] A well-documented prior authorization that links the patient's cardiovascular risk profile to the EMPA-REG OUTCOME and EMPEROR-Reduced trial data has the highest chance of success.

Patients who qualify for both Medicare and NH Medicaid (dual eligibles) may find empagliflozin covered under their Medicare Part D plan, which operates under a separate formulary from NH Medicaid. Checking the specific Part D plan's formulary at the Medicare Plan Finder tool is the correct first step for dual-eligible NH residents. [5]

Is Compounded Empagliflozin Legal in New Hampshire?

Compounded empagliflozin prepared by a licensed 503A compounding pharmacy is legal in New Hampshire. A 503A pharmacy compounds medications for individual patients based on a valid prescriber-patient relationship and a legitimate medical need, operating under state pharmacy board oversight and applicable FDA guidance. [6]

New Hampshire's Board of Pharmacy licenses 503A compounding pharmacies under RSA 318 and New Hampshire Administrative Rules Ph 400, which align with federal DQSA (Drug Quality and Security Act) standards. A licensed prescriber in NH can write a prescription for compounded empagliflozin directed to a 503A pharmacy, and the pharmacy can prepare and dispense it to the patient.

Cost is the primary driver of patient interest. Compounded empagliflozin from a licensed 503A pharmacy commonly costs $0 to $150 per month depending on the pharmacy's pricing model, compared to the $680 retail list price for branded Jardiance. Some telehealth platforms that operate 503A-affiliated pharmacies offer compounded empagliflozin at no medication cost when bundled with a membership or consultation fee.

Important caveats apply. Compounded products are not FDA-approved and have not undergone the same bioequivalence testing as Jardiance. [7] The active pharmaceutical ingredient (API) sourcing, sterility standards, and dose accuracy depend on the individual pharmacy's quality controls. Patients switching from brand Jardiance to a compounded formulation should tell their prescriber so that monitoring for glycemic control (HbA1c) and renal function (eGFR, urine albumin-to-creatinine ratio) can be repeated within 60 to 90 days of the switch.

503B outsourcing facilities, which compound in bulk without patient-specific prescriptions, may not legally dispense empagliflozin to NH patients because empagliflozin is not on the FDA's 503B Bulks List. [8] Any NH patient receiving compounded empagliflozin should confirm the dispensing pharmacy holds a 503A license, not a 503B designation.

Which Insurance Plans Cover Jardiance in New Hampshire?

Most commercial insurance plans available through the NH Health Insurance Marketplace (HealthCare.gov) and employer-sponsored plans cover Jardiance, typically on Tier 3 (preferred brand) or Tier 4 (non-preferred brand). Tier placement determines the copay or coinsurance the patient pays. [9]

A Tier 3 placement generally results in a copay of $45 to $100 per month after the deductible is met. A Tier 4 placement may require 25 to 50 percent coinsurance, which on a $680 drug calculates to $170 to $340 per fill even with active coverage. Annual deductibles on ACA Marketplace plans in NH averaged $4 to 500 in 2024, meaning many patients pay the full $680 per month during the deductible accumulation period. [10]

The following insurer types active in NH commonly list Jardiance on their commercial formularies, though specific tier placement changes annually:

Anthem Blue Cross Blue Shield of NH. Anthem's NH commercial formulary has placed empagliflozin on Tier 3 in recent plan years, with prior authorization required for the 25 mg strength in some benefit designs.

Harvard Pilgrim Health Care. Harvard Pilgrim covers empagliflozin on its NH plans, with step-therapy requirements in some tiers mandating a prior trial of metformin.

Ambetter from NH Healthy Families. This ACA Marketplace plan has listed Jardiance as non-preferred in some plan years, requiring prior authorization documentation.

Medicare Part D plans in NH. Coverage varies by plan. The CMS 2024 Part D formulary data shows that the majority of stand-alone Part D plans in NH cover at least one SGLT2 inhibitor, though not all prefer empagliflozin over dapagliflozin or canagliflozin. [11]

Patients should run a formulary check using their specific plan ID at the insurer's online drug lookup tool or call the pharmacy benefits number on the back of their insurance card before filling a prescription. Formulary tiers change on January 1 each year.

How Does the Boehringer Ingelheim / Lilly Savings Card Work in New Hampshire?

Commercially insured NH patients who are not enrolled in a government program (Medicare, Medicaid, TRICARE, or VA) may use the Jardiance savings card offered through the Boehringer Ingelheim / Eli Lilly co-pay assistance program to pay as little as $10 per month for a 30-day supply.

The program works as a co-pay card: the manufacturer covers the remaining balance after the patient pays the first $10, up to an annual maximum benefit cap (historically $150 per month or $1,800 per year, though the exact cap is updated annually). Patients register at the official Jardiance savings program website, print or download the card, and present it at participating pharmacies alongside their insurance card. [12]

Eligibility rules are strict. Patients enrolled in Medicare Part D, NH Medicaid, or any other federal or state government payer are statutorily excluded from using the co-pay card. Using the card while enrolled in a government program violates federal anti-kickback statutes and could constitute fraud. Patients who age into Medicare must stop using the card at the point of Part D enrollment.

For uninsured patients or those whose insurance does not cover Jardiance, Boehringer Ingelheim and Lilly also offer the Lilly Insulin Value Program and separate patient assistance programs. The BI Cares Foundation may provide Jardiance at no cost to patients who meet income requirements (typically at or below 400% of the federal poverty level) and lack adequate insurance coverage. [13] Applications are submitted through the prescriber's office with supporting income documentation.

What Are the Cheapest Ways to Get Jardiance in New Hampshire?

The four lowest-cost access pathways for empagliflozin in NH in 2026, ranked from lowest to highest expected monthly out-of-pocket cost, are:

1. Patient assistance program. Qualifying low-income uninsured or underinsured NH patients can receive Jardiance at no cost through the BI Cares Foundation. Monthly cost: $0. [13]

2. Compounded empagliflozin via 503A pharmacy. Legal in NH with a valid prescription. Monthly cost: $0 to $150 depending on the pharmacy and any platform fees.

3. Manufacturer savings card (commercially insured only). Reduces out-of-pocket to $10 per month for eligible patients. Monthly cost: $10. [12]

4. GoodRx or pharmacy coupon at a discount-friendly NH pharmacy. Prices at participating pharmacies range from $480 to $560 per month in 2026. Monthly cost: $480 to $560.

The patient assistance and savings card programs require annual re-enrollment. Prescribers' offices in NH can assist with the BI Cares paperwork; many practices with chronic disease management coordinators handle these applications routinely.

Can I Get a Jardiance Prescription via Telehealth in New Hampshire?

Telehealth prescribing of Jardiance is fully legal in New Hampshire. NH adopted permanent telehealth prescribing rules following the COVID-19 public health emergency, allowing licensed providers to establish a prescriber-patient relationship and issue a valid prescription for non-controlled substances without an in-person visit. [14]

Empagliflozin is a non-controlled substance. A licensed MD, DO, NP, or PA practicing in NH (or licensed in a state with an active interstate compact agreement with NH) can assess a patient via synchronous audio-video telehealth and prescribe Jardiance or a compounded equivalent. The prescriber must conduct an appropriate clinical evaluation, including review of the patient's HbA1c, eGFR, and blood pressure, before initiating an SGLT2 inhibitor. [15]

Telehealth platforms that offer empagliflozin prescribing in NH typically follow this sequence: online intake questionnaire, lab review (patients upload recent results or order through the platform's lab partner), synchronous video visit, prescription sent electronically to a pharmacy of the patient's choice or the platform's affiliated 503A compounding pharmacy.

Patients with eGFR <20 mL/min/1.73 m² should not start empagliflozin for glycemic management, as the glucose-lowering effect is substantially diminished at that level of kidney function, per the FDA-approved labeling. [1] Telehealth prescribers in NH are expected to screen for this contraindication during the intake process.

Clinical Background: Why Empagliflozin Matters

Empagliflozin belongs to the SGLT2 inhibitor class, which blocks sodium-glucose cotransporter-2 in the proximal tubule of the kidney, reducing renal glucose reabsorption by approximately 90 grams per day and producing glycosuria, mild osmotic diuresis, and natriuresis. [16]

The EMPA-REG OUTCOME trial (N=7,020, median follow-up 3.1 years) showed a 38% relative risk reduction in cardiovascular death versus placebo in adults with type 2 diabetes and established atherosclerotic cardiovascular disease. [3] Hospitalization for heart failure was reduced by 35% (hazard ratio 0.65 to 95% CI 0.50 to 0.85). These findings changed prescribing practice globally.

The EMPEROR-Reduced trial (N=3,730) confirmed a 25% relative risk reduction in the composite of cardiovascular death or hospitalization for heart failure in patients with heart failure with reduced ejection fraction (HFrEF), irrespective of diabetes status (hazard ratio 0.75 to 95% CI 0.65 to 0.86, P<0.001). [17] The EMPEROR-Preserved trial (N=5,988) then showed benefit in heart failure with preserved ejection fraction (HFpEF), a population with very few prior evidence-based therapies. [18]

The EMPA-KIDNEY trial (N=6,609) extended the evidence to chronic kidney disease, showing a 28% relative risk reduction in kidney disease progression or cardiovascular death (hazard ratio 0.72 to 95% CI 0.64 to 0.82, P<0.001). [19]

The 2023 American Diabetes Association Standards of Care recommend empagliflozin (or another SGLT2 inhibitor with proven benefit) for patients with type 2 diabetes and established ASCVD, heart failure, or CKD, independent of HbA1c or the need for additional glucose lowering. [20] The ADA states: "In patients with type 2 diabetes and established cardiovascular disease or at high cardiovascular risk, an SGLT2 inhibitor with demonstrated cardiovascular benefit is recommended to reduce the risk of major adverse cardiovascular events and/or heart failure hospitalization." [20]

The 2022 AHA/ACC/HFSA Heart Failure Guideline gave empagliflozin a Class I recommendation (Level of Evidence A) for symptomatic patients with HFrEF: "In patients with symptomatic chronic HFrEF, SGLT2 inhibitors are recommended to reduce hospitalization for HF and cardiovascular mortality." [4]

The following decision framework summarizes which NH patients are most likely to access empagliflozin at lowest cost given the current coverage environment:

| Patient profile | Best access pathway | |---|---| | Commercially insured, HbA1c documented, eGFR ≥20 | Savings card ($10/month) | | Uninsured, income ≤400% FPL | BI Cares patient assistance ($0) | | NH Medicaid only, no Medicare | Prior auth appeal + 503A compounded if denied | | Medicare Part D | Check Part D formulary; appeal if non-preferred | | Any payer, prefers telehealth | NH-licensed telehealth provider + preferred pharmacy |

Monitoring Requirements for NH Patients Starting Empagliflozin

Starting empagliflozin in an NH patient requires a baseline lab panel and repeat testing at defined intervals. These requirements apply whether the prescription is issued in person or via telehealth.

Baseline (before first dose). Serum creatinine and eGFR, urine albumin-to-creatinine ratio (UACR), HbA1c, blood pressure, complete metabolic panel. Empagliflozin is not recommended for initiation if eGFR <20 mL/min/1.73 m² and has attenuated glycemic efficacy below eGFR 45 mL/min/1.73 m². [1]

At 3 months. Repeat HbA1c and eGFR. The ADA recommends an eGFR-based dose review at this interval. [20]

Ongoing. Annual HbA1c, eGFR, UACR, and blood pressure. Patients should be counseled on genital mycotic infection risk (incidence approximately 10% in women, 4% in men across clinical trials) and the rare but serious risk of Fournier's gangrene, which carries an FDA boxed warning. [21] Patients should also hold empagliflozin 3 to 4 days before any major surgery or prolonged fasting period to reduce the risk of euglycemic diabetic ketoacidosis, a class effect of SGLT2 inhibitors. [22]

Side Effects and Contraindications

The most common adverse effects observed in clinical trials of empagliflozin include urinary tract infections (reported in 9.3% of empagliflozin-treated patients vs. 7.6% placebo in EMPA-REG OUTCOME), genital mycotic infections, and increased urination. [3] Volume depletion, hypotension, and dizziness occur more often in patients taking loop diuretics concurrently.

Absolute contraindications per FDA labeling include: dialysis dependence, hypersensitivity to empagliflozin or any excipient, and type 1 diabetes (not approved for this indication; risk of DKA). [1] Relative contraindications include recurrent UTIs, recurrent genital fungal infections, and active lower limb wounds given the historical (later de-emphasized) amputation signal seen with canagliflozin in CANVAS. [23] The EMPA-REG OUTCOME data did not show a significant amputation signal for empagliflozin specifically.

Prescribers in NH should review the full FDA-approved prescribing information before initiating empagliflozin and discuss the individualized benefit-risk profile with each patient, particularly those with a history of frequent UTIs or recurrent mycotic infections.

NH-Specific Pharmacy and Formulary Resources

NH residents have several state-level and national resources to identify the lowest-cost dispensing option:

NH DHHS Medicaid Drug Lookup. The NH Department of Health and Human Services publishes its Medicaid preferred drug list online, allowing patients and prescribers to verify coverage status before submitting a prior authorization. [24]

Medicare Plan Finder (CMS). NH residents on Medicare can compare Part D formularies by drug name at Medicare.gov, filtering by ZIP code and plan type to identify which plans cover empagliflozin at the lowest tier. [5]

GoodRx / RxSaver. Free coupon tools that aggregate negotiated prices at NH retail pharmacies. These coupons are not insurance and cannot be combined with a co-pay card or insurance benefit, but they can represent 15 to 30 percent savings off the $680 list price for cash-paying patients.

BI Cares Foundation. The Boehringer Ingelheim patient assistance program accepts applications from NH residents. Processing typically takes 2 to 4 weeks; prescribers can submit on behalf of the patient. [13]

NH 211. The statewide 211 helpline connects NH residents with prescription assistance programs, including state-funded programs for seniors under the Prescription Drug Assistance Program (PDAP), which may help bridge costs for Medicare patients in the coverage gap.

New Hampshire does not have a state-run empagliflozin subsidy program independent of federal Medicaid or Medicare structures as of 2025. The federal Inflation Reduction Act's $2,000 annual Part D out-of-pocket cap, effective January 1, 2025, provides meaningful relief for NH Medicare patients who require Jardiance at non-preferred tier pricing. [25]