Why Is Bexagliflozin The Cheapest SGLT-2 Inhibitor?

A few months back, I compared one of the newest SGLT2 inhibitors in bexagliflozin to the other agents in this class of medication. To sum up my analysis, bexagliflozin provided nothing significantly different from the other SGLT2 inhibitors. In fact, it has less evidence of benefit in disease states other than diabetes. At that time, I did not have any pricing information on bexagliflozin so was unable to review how cheap it was going to be.

I wouldn’t be posting unless something changed…so what happened? Bexagliflozin is the cheapest SGLT-2 inhibitor on the market and it isn’t by 5-10 dollars. Bexaglfilzon is priced at around 50$. For a new medication, this is historically low. I cannot think of a scenario like this throughout my career. The company has decided to do this to gain market share of what is a frequently used class of diabetes medication.

Is this or has this interrupted the usual prescribing of medications? Time will tell, but I haven’t seen it much in my area yet. Empagliflozin and dapagliflozin are typically cash-priced in the 500$ range leaving a large gap in cost between SGLT -2 Inhibitors. Insurance coverage will typically dictate the selection of medications within a class. The cash price of bexagliflozin is approximately 10% of the cost of some of the other SGLT2 inhibitors.

I’m still trying to process this, but ultimately, a reduction in the cost of brand-name prescription medications is welcomed with open arms by me! The greatest challenge at this point is the lack of other indications that some of the other mainstay drugs have such as heart failure and CKD.

What do you think about bexagliflozin being the cheapest SGLT-2 Inhibitor by a long shot? Does it change the way you prescribe/recommend SGLT-2 Inhibitors or are your patients locked into formulary SGLT-2 inhibitors? I’m still a little cynical and am wondering if they are going to try to get people started on it and then slowly raise the price over the course of a few years.

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