Farxiga costs around $377 for a 30-day supply without insurance, or roughly $12.57 per tablet at U.S. pharmacies. That price tag reflects a combination of patent protection, an expanding list of approved uses, the lack of a generic alternative, and the unique way drug pricing works in the United States. Here’s what’s driving the cost and what options exist to bring it down.
No Generic Exists Yet
The single biggest reason Farxiga remains expensive is that AstraZeneca holds patent protection on the drug through March 2028. Until that patent expires, no other manufacturer can produce a generic version of dapagliflozin (the active ingredient). Brand-name drugs without generic competition face no pricing pressure from cheaper alternatives, so the manufacturer has wide latitude to set and maintain a high list price.
For context, when generics do enter the market for other drug classes, prices typically drop by 80% or more within a few years. That relief is still a few years away for Farxiga.
An Expanding Market Keeps Demand High
Farxiga was first approved in 2014 as a diabetes medication. Since then, it has gained additional approvals that dramatically widened the number of people who take it. It is now approved for four distinct uses: improving blood sugar control in type 2 diabetes, reducing the risk of hospitalization for heart failure, protecting kidney function in chronic kidney disease, and lowering cardiovascular risk in people with type 2 diabetes who also have heart disease.
Each new approval brought millions of additional potential patients into the market. A drug that treats one condition has a certain sales ceiling. A drug that treats four overlapping conditions, including heart failure and kidney disease (two of the most common chronic illnesses), has an enormous one. That broad demand gives AstraZeneca little incentive to lower the price voluntarily.
U.S. Prices Dwarf What Other Countries Pay
The cost gap between the U.S. and other countries is striking. At American pharmacies, Farxiga runs about $11.76 per tablet on average. The same tablet costs roughly $4.17 to $4.83 when sourced from Canadian pharmacies and $3.93 to $4.46 from the United Kingdom. At accredited international pharmacies, the lowest available price drops to about $0.71 per tablet, a 93% discount compared to the average U.S. retail price.
This disparity exists because most other high-income countries negotiate drug prices at the national level, setting caps on what pharmaceutical companies can charge. The U.S. has historically lacked that kind of centralized bargaining power for most of its population, leaving prices largely up to the manufacturer.
Rebates Don’t Reach Your Wallet
The list price you see at the pharmacy counter isn’t necessarily what your insurance plan pays. Insurers and pharmacy benefit managers negotiate confidential rebates with manufacturers, sometimes clawing back a significant share of the sticker price. For similar specialty drug classes, rebates can exceed 60% of the list price. But those savings flow to insurers and middlemen rather than reducing your copay or coinsurance at the register.
This system creates a perverse incentive: manufacturers can raise list prices knowing that much of the increase gets rebated back. Meanwhile, patients without insurance, or those with high-deductible plans, get stuck paying the full inflated price.
Its Closest Competitor Isn’t Cheaper
Jardiance, the most direct alternative to Farxiga, belongs to the same drug class and treats many of the same conditions. But it doesn’t offer much price relief. A 30-day supply of Jardiance costs about $298 without insurance, and at $19.84 per tablet it’s actually more expensive on a per-unit basis (the lower monthly total reflects a different dosing quantity of 15 tablets rather than 30). When neither drug in a class undercuts the other, there’s no competitive pressure to drive prices down.
Medicare Negotiation Will Cut the Price in 2026
Farxiga was selected as one of the first drugs subject to price negotiation under the Inflation Reduction Act. Starting in 2026, Medicare will pay a negotiated price of $178.50 for a 30-day supply, roughly half the current retail price. This applies only to Medicare beneficiaries, so it won’t directly affect what people with private insurance or no insurance pay. Still, it represents the first time the federal government has used its purchasing power to set a price ceiling on this drug.
Ways to Lower Your Out-of-Pocket Cost
If you’re paying full price or facing a steep copay, several options can help. Pharmacy discount tools and coupon programs commonly bring the cash price down to around $10.32 per tablet, a modest improvement but still over $300 a month.
AstraZeneca runs a patient assistance program called AZ&Me that provides Farxiga at no cost to eligible patients. To qualify, you need to be a U.S. resident with an annual income at or below 300% of the federal poverty level. For a single person, that’s $47,880 per year; for a household of four, $99,000. You also cannot have commercial insurance or government coverage other than Medicare (and if you’re on Medicare, you must not qualify for the Extra Help/Low-Income Subsidy program). If you’ve recently lost a job, lost insurance, or had a major change in income, AstraZeneca considers those circumstances in the application.
Some people with private insurance find that their plan’s formulary places Farxiga on a preferred tier with a manageable copay, particularly if their doctor can document that it’s being prescribed for heart failure or kidney disease rather than diabetes alone. Calling your insurer to ask about tier placement and prior authorization requirements is worth the effort before filling the prescription.