Dapagliflozin, generic for Farxiga, isn’t covered for Medicare Advantage plans

Dapagliflozin, the authorized generic for Farxiga^®, is not included on the covered drug list for Medicare Plus Blue℠ and BCN Advantage℠ individual plans. Farxiga, the name brand, is the preferred product on our Medicare Advantage drug list.

Our Medicare Advantage group health care plans may use different drug lists with different benefits, so please refer to the patient’s benefits online for coverage information. For example, neither Farxiga nor dapagliflozin is covered for UAW Retiree Medical Benefits Trust members.

Note: To ensure the pharmacy dispenses the name brand and the member receives the lowest out-of-pocket costs, make sure Farxiga prescriptions have “DAW1” notated. The authorized generic isn’t on our drug list, and even if approved through a drug list exception, the member will pay more than for Farxiga.

This issue directly affects the medication adherence incentive measure. We are making every effort to prevent point-of-sale issues causing members to go without their medications. It's crucial to understand that any such issues will adversely affect your patient’s medication adherence and your incentive measure.

We've also shared this information with our major retail chain pharmacies. We're here to help you manage these medication coverage issues.