Jardiance Cost in New York 2026: Prices, Insurance, Medicaid, and Compounded Options

What Is the Retail Price of Jardiance in New York in 2026?

The cash-pay retail price of Jardiance in New York tracks the national manufacturer list price of approximately $680 per month for a 30-tablet supply of either the 10 mg or 25 mg dose. Without insurance or a discount program, patients at a standard New York retail pharmacy, whether a large chain or an independent, will see quotes in that range. GoodRx and similar discount aggregators can reduce that figure modestly, often to $590, $640 depending on the borough or county, but no coupon brings the cash price below roughly $500 at a branded-product pharmacy.

Boehringer Ingelheim and Eli Lilly co-market Jardiance. The drug has no FDA-approved generic as of mid-2025, so price competition from generic manufacturers has not yet materialized [1]. The FDA's Orange Book lists empagliflozin under NDA 204629, and any generic applicant must file an ANDA and clear patent litigation before market entry is possible [2].

New York City pharmacies in high-traffic areas (Manhattan, Brooklyn hubs) sometimes show slightly higher dispensing fees than upstate pharmacies, which can push quoted cash prices a few dollars higher. Calling ahead or using an online price-comparison tool before filling is a practical step.

Empagliflozin's clinical value justifies its pricing for many patients. In the landmark EMPA-REG OUTCOME trial (N=7,020), empagliflozin 10 mg or 25 mg added to standard care reduced the composite of cardiovascular death, nonfatal myocardial infarction, or nonfatal stroke by 14% vs. placebo (hazard ratio 0.86 to 95% CI 0.74, 0.99, P<0.001 for noninferiority; P=0.04 for superiority) [3]. Cardiovascular death alone fell by 38% (HR 0.62 to 95% CI 0.49, 0.77, P<0.001) [3]. Those reductions are why cardiologists, endocrinologists, and primary care physicians across New York continue prescribing it despite the cost barrier.

The EMPEROR-Reduced trial (N=3,730) later showed that empagliflozin 10 mg reduced the risk of cardiovascular death or hospitalization for heart failure by 25% relative to placebo (HR 0.75 to 95% CI 0.65, 0.86, P<0.001), extending the drug's evidence base beyond glycemic control alone [4].

Does New York Medicaid Cover Jardiance?

New York Medicaid covers Jardiance, but a prior authorization (PA) is required. The PA criteria typically require documentation of a type 2 diabetes diagnosis, a recent HbA1c, evidence that metformin was trialed or is contraindicated, and, for heart failure or CKD indications, supporting diagnostic records. Prescribers who document these elements thoroughly tend to see PA approvals within two to five business days through the NY State Medicaid eMedNY system.

New York Medicaid Managed Care plans, including MetroPlus, Fidelis Care, Healthfirst, and Molina, each maintain their own formulary tiers and PA processes, which may differ slightly from fee-for-service Medicaid criteria. Patients enrolled in a managed care plan should ask the prescriber's office to check that specific plan's formulary rather than assuming fee-for-service rules apply.

The 2023 American Diabetes Association Standards of Care in Diabetes recommend SGLT2 inhibitors as preferred add-on therapy for patients with type 2 diabetes who have established cardiovascular disease, heart failure with reduced or mildly reduced ejection fraction, or CKD with albuminuria, independent of HbA1c level [5]. New York Medicaid PA criteria are generally aligned with these ADA recommendations, which strengthens the clinical justification for PA submissions.

For patients on Medicaid Advantage (dually eligible Medicare/Medicaid), coverage falls under the Medicare Part D plan rather than Medicaid, and formulary placement varies by plan. The Extra Help (Low Income Subsidy) program can substantially reduce Part D cost-sharing for dually eligible New Yorkers.

Is Compounded Empagliflozin Legal in New York?

Compounded empagliflozin is legal in New York when prepared by a state-licensed 503A compounding pharmacy operating under a valid individual patient prescription. It is not legal for a 503A pharmacy to compound empagliflozin in bulk without a patient-specific prescription, and 503B outsourcing facilities may not compound a drug that is not on the FDA's drug shortage list [6]. As of mid-2025, branded empagliflozin (Jardiance) is not listed on the FDA drug shortage database, which limits 503B compounding pathways [7].

New York's Board of Pharmacy enforces state-level oversight of 503A pharmacies, requiring compliance with USP Chapter 795 standards for non-sterile preparations and mandating that compounding be performed for legitimate, identified patient needs [8]. A prescriber ordering compounded empagliflozin in New York must document a clinical rationale, such as a patient requiring a dose not commercially available or a documented excipient sensitivity to an inactive ingredient in branded Jardiance tablets.

The practical cost picture for compounded empagliflozin in New York depends heavily on the individual pharmacy and formulation. Some 503A pharmacies quote prices in the $80, $150 per month range for compounded oral formulations, compared with the $680 list price for branded Jardiance. That differential is clinically meaningful for uninsured or underinsured patients, but the patient and prescriber must weigh it against the fact that compounded products do not carry FDA approval for safety, efficacy, or bioequivalence. The FDA's guidance on compounding notes that compounded drugs "lack FDA approval" and may differ in potency, purity, or stability from the reference listed drug [6].

Patients considering compounded empagliflozin should ask the pharmacy for a certificate of analysis from an independent third-party laboratory confirming the active pharmaceutical ingredient content and absence of impurities before dispensing.

Which Insurance Plans Cover Jardiance in New York?

Most commercial insurance plans available through New York's health exchange (NY State of Health) and employer-sponsored plans include Jardiance on formulary, though tier placement varies. Tier 2 (preferred brand) placement is common, resulting in copays of $40, $80 per month after deductible. Tier 3 (non-preferred brand) placement can mean $80, $150 per month or higher before any savings card is applied.

Empire BlueCross BlueShield, UnitedHealthcare, Cigna, Aetna, and Oscar Health all have Jardiance on at least one formulary tier in their New York commercial products for 2026. Step-therapy requirements (requiring a trial of metformin or another oral agent first) may apply depending on the indication and plan. For the heart failure indication (heart failure with reduced ejection fraction), some plans waive step therapy because no equivalent alternative SGLT2 inhibitor is mandated by clinical guidelines.

Medicare Part D plans sold in New York list Jardiance at varying tiers. Patients on a standard Part D plan without Extra Help who are in the catastrophic coverage phase may pay as little as $0, $35 per month under the Inflation Reduction Act's $2,000 annual out-of-pocket cap that took effect in 2025 [9]. That cap is particularly relevant for New York Medicare beneficiaries who take multiple brand-name medications.

The 2024 ACC/AHA Guideline for the Diagnosis and Treatment of Heart Failure gives SGLT2 inhibitors a Class I, Level of Evidence A recommendation for patients with HFrEF to reduce hospitalization and cardiovascular mortality [10]. When a prescriber cites that guideline in a PA letter, many commercial plans in New York will approve Jardiance at a preferred tier.

How the Boehringer Ingelheim / Lilly Savings Card Works in New York

Boehringer Ingelheim and Eli Lilly offer a Jardiance savings card (also called a copay card or prescription savings card) through the Jardiance.com patient support program. Eligible commercially insured patients in New York may pay as little as $10 per month, with the manufacturer covering up to a defined cap (historically $150 per fill) on the remaining balance.

The savings card is not valid for patients whose prescription is covered by any federal or state government program, including Medicare, Medicaid, CHIP, TRICARE, or the VA. This exclusion removes a large subset of New York patients from eligibility. Patients who are commercially insured, through an employer plan or a marketplace plan purchased with after-tax dollars, qualify, provided they are not also using a government program for the same medication.

To enroll, patients register at Jardiance.com or call the program line, then present the card (physical or digital) at any participating New York pharmacy. Most major chains and many independents participate. If a pharmacy's point-of-sale system does not process the card, the patient can submit for reimbursement manually, though this adds time.

The savings card does not work with GoodRx or other third-party discount cards simultaneously. Patients should compare the out-of-pocket total under their insurance plus the savings card against the GoodRx cash price and choose the lower figure.

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

For commercially insured New Yorkers, stacking the Boehringer Ingelheim / Lilly savings card on top of a preferred-tier insurance benefit is the most cost-effective path, often bringing monthly cost to $10, $40. For uninsured patients, options in order of likely out-of-pocket cost are:

Licensed 503A compounded empagliflozin, where a prescriber documents clinical rationale, may run $80, $150 per month at a qualifying New York pharmacy. The Jardiance patient assistance program (Lilly Cares / Boehringer Ingelheim Cares) provides branded Jardiance at no cost to qualifying patients who meet income thresholds, generally at or below 400% of the federal poverty level. Applications require income documentation and a prescriber signature [11].

New York State Medicaid, for those who qualify by income (generally up to 138% FPL for adults), covers Jardiance with PA at effectively $0, $3 per fill under Medicaid co-pay rules.

Splitting a 90-day mail-order supply through a pharmacy benefit manager often saves 10 to 15% compared with monthly 30-day fills, and several PBMs operating in New York (Express Scripts, CVS Caremark, OptumRx) offer empagliflozin through their preferred pharmacy networks at negotiated rates.

Telehealth prescribers in New York can prescribe Jardiance for established clinical indications. A telehealth visit through a licensed New York provider does not change formulary access, the prescription is filled at the same pharmacies and with the same benefit structures as an in-person visit.

Empagliflozin Dosing and Clinical Indications Relevant to Cost Coverage

Understanding which indication drives the prescription matters for coverage in New York because PA criteria differ by indication.

For type 2 diabetes, the starting dose is empagliflozin 10 mg once daily, with uptitration to 25 mg once daily for additional glycemic benefit. The EMPA-REG OUTCOME trial used both doses and demonstrated cardiovascular mortality reduction independent of baseline HbA1c [3]. New York Medicaid PA for the diabetes indication requires an HbA1c above 7.0% (or 6.5% per some plan criteria) and documentation of metformin use or contraindication.

For heart failure with reduced ejection fraction (HFrEF), the FDA approved empagliflozin 10 mg once daily based on EMPEROR-Reduced (N=3,730), which showed a 25% relative risk reduction in the primary composite endpoint [4]. For heart failure with preserved ejection fraction (HFpEF), the EMPEROR-Preserved trial (N=5,988) showed empagliflozin 10 mg reduced the risk of cardiovascular death or worsening heart failure by 21% (HR 0.79 to 95% CI 0.69, 0.90, P<0.001) [12]. The FDA approved the HFpEF indication in 2022, and New York commercial plans and Medicaid have progressively updated PA criteria to reflect this approval.

For chronic kidney disease (CKD), the EMPA-KIDNEY trial (N=6,609) showed empagliflozin 10 mg reduced the risk of kidney disease progression or cardiovascular death by 28% (HR 0.72 to 95% CI 0.64, 0.82, P<0.001) [13]. The FDA approved the CKD indication in 2023 [1]. New York Medicaid PA for CKD typically requires an eGFR between 20 to 45 mL/min/1.73m² and a urine albumin-to-creatinine ratio above 200 mg/g, consistent with KDIGO 2022 guideline criteria [14].

Prescribers writing PA letters for New York Medicaid or commercial plans should specify the exact indication, cite the relevant trial, and include the most recent lab values. A PA tied to the CKD indication, for example, is strengthened by attaching the eGFR and UACR from within the past 90 days.

Telehealth Access to Jardiance in New York

New York permits telehealth prescribing of controlled and non-controlled medications, including Jardiance, under New York Education Law Section 6530(21) and its accompanying Department of Health telehealth regulations. Empagliflozin is a non-controlled substance, so no in-person evaluation is legally mandated before a New York-licensed provider writes the first prescription via telemedicine [15].

In practice, a responsible telehealth prescriber will review relevant lab work (HbA1c, eGFR, urine albumin, comprehensive metabolic panel) before initiating empagliflozin. This is not a legal requirement but a standard-of-care expectation consistent with the ADA's 2023 Standards of Care, which call for baseline renal function assessment before SGLT2 inhibitor initiation [5].

Telehealth platforms operating in New York must employ or contract with providers holding an active New York State medical license. Prescriptions generated via telehealth are transmitted electronically to any licensed New York pharmacy and are eligible for the same savings cards and insurance benefits as prescriptions written in person.

Safety Considerations That Affect Prescribing and Cost in New York

Empagliflozin carries an FDA-required boxed warning for the risk of Fournier's gangrene (necrotizing fasciitis of the genitalia and perineum), a rare but serious adverse event reported across the SGLT2 inhibitor class [1]. Diabetic ketoacidosis (DKA), including euglycemic DKA, is also an identified risk, particularly in patients with type 1 diabetes or those undergoing surgical procedures, prolonged fasting, or severe illness. Empagliflozin is not approved for type 1 diabetes in the United States.

Genital mycotic infections occur in roughly 6 to 7% of women and 3 to 4% of men treated with SGLT2 inhibitors in clinical trials, generally mild and responsive to topical antifungals [3]. Urinary tract infections, volume depletion (especially in patients on loop diuretics), and lower limb amputations (a signal observed with canagliflozin but less prominent with empagliflozin in EMPA-REG OUTCOME) round out the key safety profile.

These safety considerations are relevant to cost because some New York managed-care plans require documentation of a safety risk assessment for volume-depleted patients or those on concurrent diuretics before approving the PA. Including a note about the patient's baseline blood pressure, eGFR, and diuretic use in the PA letter reduces back-and-forth and speeds approval.

What New York Patients Should Bring to Their First Appointment

A productive first visit, whether in person or via telehealth, for a patient seeking Jardiance in New York should include the following documentation to minimize prescription delays and insurance obstacles:

Current insurance card and a screenshot of the formulary tier for empagliflozin (available on the plan's website or app). Lab work from within the past 90 days: HbA1c, comprehensive metabolic panel (including serum creatinine and eGFR calculation), urine albumin-to-creatinine ratio if CKD is suspected, and a basic lipid panel. A list of current medications, specifically any diuretics, ACE inhibitors, ARBs, or other diabetes medications, because drug interactions and safety considerations affect dosing decisions and PA wording. Documentation of any prior SGLT2 inhibitor exposure, including tolerability, which is relevant if a plan requires step therapy through a different SGLT2 inhibitor first.

Patients who arrive with this information allow the prescriber to submit a complete PA on the same day, rather than waiting for lab orders to result over the following week.

The ADA Standards of Care note that "provider-patient communication about medication costs is an essential component of diabetes management" and recommend that clinicians routinely discuss out-of-pocket costs as part of shared decision-making [5].