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

What Is the Retail Price of Jardiance in Washington in 2026?

The average cash-pay retail price for Jardiance in Washington is $680 per month in 2026, which matches the manufacturer list price set by Boehringer Ingelheim and Eli Lilly. Both the 10 mg and 25 mg tablet strengths carry this same list price at most Washington retail chains including Walgreens, Rite Aid, and Costco Pharmacy.

Empagliflozin belongs to the sodium-glucose cotransporter-2 (SGLT-2) inhibitor class. The FDA first approved Jardiance in August 2014 for type 2 diabetes and subsequently expanded its label to include heart failure with reduced ejection fraction (HFrEF) in 2021, heart failure with preserved ejection fraction (HFpEF) in 2022, and chronic kidney disease (CKD) in 2023 [1]. Each new indication has added prescribing volume, but the list price has not decreased with generic competition because no AB-rated generic empagliflozin has yet reached U.S. market shelves as of mid-2025.

Price varies modestly by pharmacy. GoodRx coupons at Washington pharmacies have ranged from approximately $620 to $665 for a 30-day supply, depending on the specific zip code and pharmacy chain. Costco Pharmacy members in Washington have historically offered slightly lower coupon-adjusted prices than urban chain pharmacies, though still well above $600. Cash-pay patients who decline insurance billing can present a GoodRx or RxSaver coupon at the pharmacy counter, which does not require enrollment in any program.

The FDA label for Jardiance is publicly searchable through the FDA's drug approval database [1], and the drug's pharmacology, contraindications, and dosing information are maintained there with each labeling update.

Does Washington Medicaid (Apple Health) Cover Jardiance?

Washington Apple Health covers Jardiance with prior authorization (PA) for adult enrollees who meet specific clinical criteria. PA is required for all three major indications: type 2 diabetes, heart failure, and chronic kidney disease.

The Washington State Health Care Authority publishes a Preferred Drug List (PDL) that governs Apple Health coverage decisions. SGLT-2 inhibitors as a class are listed as non-preferred agents that require PA, meaning a prescribing clinician must document that the patient has a qualifying diagnosis, that first-line agents have been tried or are contraindicated, and that the clinical benefit is supported by guideline-concordant evidence [2]. The American Diabetes Association's Standards of Care in Diabetes 2024 recommends SGLT-2 inhibitors for patients with type 2 diabetes who have established cardiovascular disease, heart failure, or CKD regardless of HbA1c, a recommendation at evidence grade A [3].

Once PA is approved, Apple Health beneficiaries pay standard Medicaid cost-sharing, which in Washington is $1 to $3 per prescription fill for most outpatient drugs. This makes Apple Health one of the most cost-effective pathways for low-income Washington residents who qualify for Medicaid.

Eligibility for Apple Health in Washington extends to adults with incomes up to 138% of the federal poverty level under the ACA Medicaid expansion that Washington adopted in 2014 [4]. Patients who are not enrolled can check eligibility at Washington Healthplanfinder.

To initiate a PA request, the prescribing clinician submits clinical documentation to the patient's Apple Health managed care plan. Most PA decisions are returned within 72 hours for standard requests, or within 24 hours for urgent clinical situations under Washington Administrative Code requirements.

Which Private Insurance Plans Cover Jardiance in Washington?

Most commercial health plans sold in Washington cover Jardiance, but the tier placement and required cost-sharing vary substantially by plan design.

Large employer-sponsored plans in Washington typically place Jardiance on Tier 3 (preferred brand) or Tier 4 (non-preferred brand). A Tier 3 placement commonly carries a copay of $45 to $90 per 30-day fill, while a Tier 4 placement may require coinsurance of 25% to 40% of the negotiated price. Medicare Part D plans sold in Washington show similar variation: the Medicare formulary search tool on CMS.gov allows beneficiaries to compare exact cost-sharing by plan for any covered National Drug Code [5].

Washington State employees covered by the Public Employees Benefits Board (PEBB) plans or the School Employees Benefits Board (SEBB) plans can check Jardiance tier status through their specific plan formulary. Kaiser Permanente Washington, Premera Blue Cross, Regence BlueShield, and Molina Healthcare of Washington each maintain separate formulary documents updated annually.

The Centers for Medicare and Medicaid Services issued guidance in 2023 that SGLT-2 inhibitors with a heart failure or CKD indication must be covered without a coverage gap under Medicare Advantage plans when prescribed for those specific indications [5]. This has reduced out-of-pocket exposure for Medicare Advantage enrollees in Washington with heart failure or CKD diagnoses.

Patients with commercial insurance can call the member services number on their insurance card and ask specifically: (1) what tier Jardiance is on, (2) whether a PA is required for their diagnosis, and (3) whether any step therapy applies.

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

The Boehringer Ingelheim and Eli Lilly co-promotion savings card can reduce Jardiance out-of-pocket cost to as low as $0 per month for commercially insured patients, or to a fixed low copay, depending on insurance tier and plan type.

Eligible patients are those with commercial or private insurance who are not enrolled in any federal or state government health programs including Medicare, Medicaid, TRICARE, or any state pharmaceutical assistance program. Washington residents receiving Apple Health coverage are therefore excluded from the savings card. Patients who lose Medicaid eligibility and transition to commercial coverage may enroll at that point.

The savings card program is managed through the manufacturers' patient support line and is also accessible via the official Jardiance website. The card functions as a secondary payer: the insurance plan is billed first, and the savings card covers the remaining patient cost-share up to the program maximum, which has historically been set at $150 per fill cycle. Patients pay $0 if their copay is $150 or less [6].

Annual enrollment is required. The card is valid for 12 calendar months from activation, after which renewal is needed. Washington residents can enroll online or by calling the program's toll-free number, and the card is sent electronically or by mail within a few business days.

For patients who are uninsured and do not qualify for Medicaid, Boehringer Ingelheim and Lilly also maintain a patient assistance program (Lilly Insulin Value Program is separate) through which patients meeting income criteria may receive Jardiance at no cost. Applications are submitted through the manufacturer's patient assistance portal with proof of income documentation.

Is Compounded Empagliflozin Legal in Washington?

Compounded empagliflozin is legal in Washington when prepared by a state-licensed 503A compounding pharmacy operating under the federal Drug Quality and Security Act (DQSA) framework and Washington pharmacy regulations.

A 503A pharmacy compounds medications for specific individual patients based on a valid prescription from a licensed prescriber. Unlike 503B outsourcing facilities, which produce large batches for hospital or clinic use, 503A pharmacies customize formulations for one patient at a time. Washington State Department of Health licenses and inspects 503A pharmacies under WAC 246-869 [7].

The FDA has not placed empagliflozin on its list of drug substances that may be compounded under section 503A of the DQSA, but it also has not prohibited it as a substance on the 503A Difficult to Compound or Demonstrably Difficult lists. The practical result is that licensed 503A pharmacies in Washington may compound empagliflozin capsules or suspensions when a prescriber provides a patient-specific prescription with a documented clinical rationale [8].

Compounded empagliflozin is not bioequivalent to FDA-approved Jardiance tablets. No head-to-head pharmacokinetic trial has compared compounded SGLT-2 formulations to Jardiance. The bioavailability, dissolution characteristics, and impurity profiles of compounded versions may differ from the reference listed drug. Clinicians at HealthRX who prescribe compounded empagliflozin document the clinical rationale and counsel patients that the compounded product is not FDA-approved.

Cash-pay prices for compounded empagliflozin at Washington 503A pharmacies range widely, but are generally between $60 and $180 per month depending on dose and formulation, compared to $680 per month for brand Jardiance. Some compounding pharmacies working with telehealth platforms offer pricing substantially below the brand list price. Insurance and government programs generally do not reimburse compounded medications.

HealthRX Clinical Pathway: Matching Washington Patients to the Lowest Effective Empagliflozin Cost

The HealthRX medical team uses a four-step decision sequence when evaluating empagliflozin access for Washington patients:

1. Confirm diagnosis and indication (T2D, HFrEF, HFpEF, or CKD) with supporting labs or specialist notes.
2. Check insurance formulary tier and PA requirements before prescribing. If Tier 3 or 4 with PA, submit PA simultaneously with the prescription.
3. Apply the manufacturer savings card for commercially insured patients whose copay exceeds $10/month. For Apple Health patients, proceed directly to PA submission.
4. For uninsured patients or those with denied PA, evaluate compounded empagliflozin from a Washington-licensed 503A pharmacy with documented clinical rationale and patient counseling on non-equivalence.

This sequence minimizes time-to-therapy and avoids unnecessary step therapy delays that can exceed 30 days if PA is not submitted concurrently with the initial prescription.

What Does the Clinical Evidence Say About Empagliflozin?

The cost of any medication needs to be weighed against the clinical benefit it provides. Empagliflozin has unusually strong outcome data from large cardiovascular and renal trials.

EMPA-REG OUTCOME enrolled 7,020 adults with type 2 diabetes and established cardiovascular disease across 42 countries. Empagliflozin 10 mg or 25 mg once daily reduced the risk of the primary composite endpoint (cardiovascular death, nonfatal myocardial infarction, or nonfatal stroke) by 14% relative to placebo (HR 0.86 to 95% CI 0.74 to 0.99, P<0.001 for non-inferiority; P=0.04 for superiority) [9]. Cardiovascular death specifically was reduced by 38% (HR 0.62 to 95% CI 0.49 to 0.77, P<0.001) [9]. This was the first cardiovascular outcomes trial for any glucose-lowering drug to show a statistically significant reduction in cardiovascular mortality.

EMPEROR-Reduced (N=3,730) showed that empagliflozin 10 mg daily reduced the composite of cardiovascular death or hospitalization for heart failure by 25% relative to placebo (HR 0.75 to 95% CI 0.65 to 0.86, P<0.001) in patients with HFrEF [10]. This benefit appeared within 12 days of starting treatment.

EMPEROR-Preserved (N=5,988) extended these findings to HFpEF, showing a 21% reduction in the same composite endpoint (HR 0.79 to 95% CI 0.69 to 0.90, P<0.001) [11]. EMPEROR-Preserved was the first large trial to demonstrate a pharmacologic benefit in HFpEF, a condition that had resisted effective treatment for decades.

EMPA-KIDNEY (N=6,609) examined empagliflozin in patients with CKD across a broad range of eGFR (as low as 20 mL/min/1.73m2). The primary outcome, a composite of kidney disease progression or cardiovascular death, was reduced by 28% (HR 0.72 to 95% CI 0.64 to 0.82, P<0.001) [12]. The trial was stopped early for efficacy.

The ADA Standards of Care 2024 assign a Grade A recommendation to SGLT-2 inhibitors for adults with type 2 diabetes and established CVD, multiple CVD risk factors, CKD, or heart failure [3]. The American Heart Association and American College of Cardiology heart failure guidelines similarly recommend SGLT-2 inhibitors as Class I therapy for HFrEF and Class IIa for HFpEF [13].

These outcome data matter for Washington patients making cost-benefit decisions. A drug that costs $680/month and reduces 3-year risk of cardiovascular death by 38% presents a different value calculation than a drug with only glycemic efficacy.

Can I Get Jardiance via Telehealth in Washington?

Washington permits telehealth prescribing of Jardiance (empagliflozin) for new and established patients under current state law.

Washington was among the first states to adopt comprehensive telehealth parity legislation. RCW 74.09.325 and related statutes require most commercial insurers to reimburse telehealth visits at parity with in-person visits for covered services [14]. This means a telehealth visit with a Washington-licensed prescriber to evaluate a patient for empagliflozin is both legal and typically reimbursable through commercial insurance and Apple Health.

Prescribers must hold a Washington state license or a license recognized through interstate compacts. The prescriber must conduct a clinically appropriate evaluation before writing a new prescription, which for empagliflozin includes confirming diagnosis, reviewing contraindications (eGFR <20 mL/min/1.73m2 for CKD dosing limits, history of recurrent DKA, genital mycotic infections), and reviewing baseline labs [1].

HealthRX clinicians are licensed in Washington and can prescribe empagliflozin through synchronous video visits. Lab results (HbA1c, eGFR, urine albumin-to-creatinine ratio) can be ordered through partner labs with Washington draw sites, with results reviewed before prescribing. Turnaround from initial consultation to pharmacy fulfillment is typically 24 to 48 hours.

Washington's telehealth framework was reinforced by the 2021 Telehealth Advancement Act (ESHB 1196), which removed restrictions on originating site requirements for most telehealth encounters, allowing patients to connect from home rather than requiring a clinic visit [14].

How Do SGLT-2 Inhibitor Side Effects Affect Long-Term Cost Calculations?

Side effects from empagliflozin are generally mild but carry some specific risks that clinicians and patients should factor into the full cost picture.

The most common adverse effect is genital mycotic infection (yeast infection), occurring in approximately 5.4% of women and 1.5% of men taking empagliflozin in clinical trials [1]. These respond readily to standard antifungal treatment but add a cost layer for affected patients. Urinary tract infections occur at a rate similar to placebo in most trial data.

Diabetic ketoacidosis (DKA) is a rare but serious risk, occurring at an incidence of approximately 0.1% per year in type 2 diabetes patients in post-marketing data, with higher risk in patients using insulin or with very low carbohydrate intake [15]. The FDA added a Boxed Warning to all SGLT-2 inhibitors for this risk in 2015 [1]. Patients should be counseled to hold empagliflozin 3 to 4 days before elective surgery or prolonged fasting.

Fournier's gangrene (necrotizing fasciitis of the perineum) has been reported in fewer than 100 cases across the entire SGLT-2 inhibitor class in post-marketing surveillance through 2024, representing a very rare but severe risk [15].

Volume depletion manifesting as dizziness or hypotension may occur, particularly in patients over age 75 or those on loop diuretics. The EMPA-REG OUTCOME trial reported volume depletion events in 2.1% of the empagliflozin group vs. 1.4% placebo [9].

What Is the Cheapest Way to Get Empagliflozin in Washington?

The lowest-cost pathway depends on insurance status and clinical eligibility.

For Apple Health enrollees with an approved PA, the patient cost is $1 to $3 per fill. For commercially insured patients with the manufacturer savings card applied, the cost may be $0 per month. For uninsured Washington residents who do not qualify for Medicaid and do not meet savings card income thresholds, compounded empagliflozin from a licensed 503A pharmacy is the most affordable option at roughly $60 to $180 per month, compared to $680 cash-pay for brand Jardiance.

GoodRx and RxSaver discount codes at Washington pharmacies reduce the brand price to approximately $620 to $665 for a 30-day supply. NeedyMeds.org lists additional Washington-based pharmaceutical assistance resources for patients who have exhausted other options [16].

The Lilly Cares Foundation Patient Assistance Program and the Boehringer Ingelheim Cares Foundation each accept applications from uninsured patients with annual household incomes below 400% of the federal poverty level, which is approximately $60,240 for a single adult in 2025 [6]. Approved applicants receive Jardiance at no cost shipped directly to their physician's office or to a pharmacy.

Patients should not purchase empagliflozin from international online pharmacies without a valid U.S. prescription, as this violates federal importation laws and carries risks of counterfeit product, incorrect dose, or contaminated formulation.

Monitoring Requirements That Affect the Total Cost of Therapy

Empagliflozin requires baseline and periodic laboratory monitoring that adds to the total annual cost of therapy.

Before starting empagliflozin, a prescriber should confirm eGFR and serum creatinine. Dosing for CKD indications is adjusted based on eGFR thresholds: the drug is not recommended for initiation below eGFR 20 mL/min/1.73m2 for CKD and may be continued in some heart failure patients at lower eGFR values [1]. HbA1c should be checked at baseline for type 2 diabetes patients.

The ADA recommends HbA1c monitoring every 3 months until glycemic targets are achieved, then every 6 months [3]. eGFR should be rechecked at 3 to 6 months after starting therapy, as SGLT-2 inhibitors predictably cause a small acute reduction in eGFR (typically 2 to 5 mL/min/1.73m2) that is hemodynamic and reversible, not nephrotoxic, before the long-term renoprotective trajectory becomes apparent [12].

Urine albumin-to-creatinine ratio (UACR) should be checked at baseline in CKD and diabetes patients and annually thereafter per KDIGO 2024 guidelines [17]. This is relevant in Washington because Apple Health covers lab services, reducing monitoring costs for Medicaid enrollees to minimal copays, while uninsured patients may pay $30 to $80 per lab draw depending on the facility.

For Washington patients using HealthRX telehealth services, lab orders can be sent to Quest Diagnostics or LabCorp draw sites across the state, with results transmitted electronically and reviewed by the HealthRX clinical team before the follow-up telehealth visit.