SGLT2 Cost Comparison 2026: Jardiance vs Farxiga vs Invokana

Jardiance (empagliflozin, Boehringer Ingelheim/Eli Lilly), Farxiga (dapagliflozin, AstraZeneca), and Invokana (canagliflozin, Janssen) are the three leading SGLT2 inhibitors sold in the United States in 2026. All three are once-daily oral tablets approved to lower blood sugar in type 2 diabetes, and all three carry expanded FDA approvals for reducing cardiovascular death and hospitalization in heart failure and slowing chronic kidney disease progression. The three drugs are not interchangeable in every indication. Jardiance and Farxiga both hold approval for heart failure with preserved ejection fraction (HFpEF); Invokana's label centers on diabetic kidney disease and does not carry the same HFpEF indication. Patients switched between them for cost reasons should confirm the substitution matches their specific diagnosis with their prescriber.

As oral tablets dispensed through retail pharmacies, all three drugs are billed under Medicare Part D (the pharmacy drug benefit), not Medicare Part B, and none carries an HCPCS J-code. That is where the similarity ends on the Medicare side. Jardiance and Farxiga were both selected as part of the first 10 drugs subject to Medicare price negotiation under the Inflation Reduction Act (Public Law 117-169, signed August 16, 2022), with negotiated Maximum Fair Prices effective January 1, 2026. Invokana was not selected for either negotiation round, so it remains priced by each Part D plan's own formulary tier and prior authorization criteria. Farxiga's generic (dapagliflozin) received FDA approval on April 7, 2026, the only one of the three with a generic on the market as of mid-2026.

CoveredUSA's SGLT2 comparison covers cash retail prices, GoodRx and SingleCare pharmacy pricing, Medicare Part D coverage differences, generic status, manufacturer patient assistance programs, and what to do if your plan denies coverage or requires step therapy across the class. For a deeper single-drug breakdown, see the dedicated pages for Jardiance and Farxiga. Patients unsure whether they qualify for Medicaid should check the Medicaid income limits guide, and Medicare beneficiaries who need help affording any of these drugs should review Medicare eligibility and Part D Extra Help.

What SGLT2 Inhibitor Costs 2026 Costs by Point of Pay (2026)

The price you pay depends almost entirely on WHERE you pay. The same sglt2 inhibitor costs 2026 can cost many times more at a hospital than at your local pharmacy:

Why Hospitals Charge So Much

Jardiance, Farxiga, and Invokana are self-administered oral tablets dispensed mainly through retail pharmacies, so inpatient hospital billing for any of the three is uncommon. When a hospitalized patient is already taking one of these drugs at home, the hospital typically continues it during the stay and bundles the charge into the DRG (Diagnosis-Related Group) payment under Medicare Part A rather than billing it as a separate pharmacy line item.

When one of the three does appear as a separate line item, hospital chargemasters typically list them at 1.5x to 3x the retail acquisition cost, producing charges of $900 to $1,800 for a supply that cost the hospital $400 to $600 to acquire. Patients who see any SGLT2 inhibitor billed separately should request an itemized bill and compare the charge against the hospital's own CMS-mandated price transparency files.

One clinical note applies to all three drugs: CMS and clinical society guidelines recommend stopping SGLT2 inhibitors before surgery, prolonged fasting, or contrast-dye procedures due to the risk of euglycemic diabetic ketoacidosis (euDKA). If a patient is admitted for a surgical procedure, the hospital may legitimately hold the drug during the stay. Patients should verify they are not billed for a dose on a day the medication reconciliation note shows it was clinically held; that is a common and disputable billing discrepancy.

Patient Assistance Programs

Each manufacturer runs its own patient assistance program and commercial savings card. Boehringer Ingelheim operates BI Cares for Jardiance, AstraZeneca offers a savings card plus patient support line for Farxiga (its AZ&Me free-drug program stopped accepting new Farxiga patients May 1, 2026 after the generic approval), and Janssen operates the Janssen CarePath savings program and patient assistance program for Invokana. Manufacturer coupon cards are only for commercially insured patients; none can be used by anyone on Medicare, Medicaid, TRICARE, or VA benefits under federal anti-kickback law:

Medicare Part D

Medicare Part D coverage differs across the three drugs in 2026. Jardiance and Farxiga carry federally mandated IRA-negotiated Maximum Fair Prices of $197 and $178.50 per 30-day supply, which every Part D plan, including Medicare Advantage prescription drug (MA-PD) plans, must honor by law. Invokana was not selected for either negotiation round, so its cost sharing depends entirely on each plan's formulary tier placement and whether prior authorization or step therapy is required. All three drugs, along with every other Part D prescription, count toward the 2026 annual out-of-pocket cap of $2,100; once you cross that threshold in a calendar year, covered drugs cost $0 for the rest of the year.

Enrollees with the Low-Income Subsidy (Extra Help) generally pay approximately $11 per fill for Jardiance or Farxiga regardless of the Maximum Fair Price, and typically a comparably low copay for Invokana if their plan places it on a lower formulary tier. If your plan charges more than $197 for Jardiance or $178.50 for Farxiga in 2026, contact your plan's member services and request they apply the Maximum Fair Price; plans are legally required to honor it. For Invokana, if your plan denies coverage or places it on a high specialty tier, ask your prescriber whether Jardiance or Farxiga, both with lower negotiated Medicare prices, would be clinically appropriate substitutes.

Common SGLT2 Inhibitor Costs 2026 Billing Errors

All three SGLT2 inhibitors are oral tablets with no J-code, so billing problems typically involve formulary tier errors, IRA price application failures, and cross-drug substitution rather than HCPCS coding errors. Check for these before paying:

• Part D plan charged more than $197 for Jardiance or $178.50 for Farxiga per 30-day fill in 2026: the Maximum Fair Price is federally mandated; request the plan apply it and file a coverage determination dispute if declined
• Pharmacy substituted one SGLT2 inhibitor for another (Jardiance for Farxiga, or vice versa) without prescriber authorization: they are not therapeutically interchangeable for every FDA-approved indication, particularly heart failure with preserved ejection fraction
• Generic dapagliflozin dispensed for a patient specifically prescribed brand Farxiga without confirming generic substitution is appropriate for their indication
• Wrong formulary tier applied: any of the three placed on a specialty tier (Tier 4 or 5) instead of Tier 2 or 3, inflating cost-sharing above the negotiated or expected price
• Manufacturer savings card payment blocked by a commercial plan's accumulator adjustment program, so the copay card amount does not count toward the deductible
• Inpatient billing for a dose that was clinically held before surgery due to euglycemic diabetic ketoacidosis risk; verify against the medication reconciliation note before paying

Frequently Asked Questions