Watch for Bexagliflozin, a New Med for Type 2 Diabetes

You’ll hear buzz about new Rx bexagliflozin (Brenzavvy).

Think of it as similar to other SGLT2 inhibitors for type 2 diabetes...dapagliflozin, empagliflozin, etc.

A big difference is that bexagliflozin will cost about $50 per month...versus about $600 per month for other SGLT2 inhibitors.

But bexagliflozin won’t be covered by most payers yet.

And it’ll only be available through a single online pharmacy at first...anticipate distribution to broaden over the next couple months.

Don’t expect all patients to jump to bexagliflozin.

Bexagliflozin improves blood sugar similar to other SGLT2 inhibitors in patients with type 2 diabetes.

But so far, evidence isn’t strong enough to say that it reduces the risk of cardiovascular events, heart failure, or chronic kidney disease progression like some SGLT2 inhibitors.

If patients are considering bexagliflozin, encourage them to compare the out-of-pocket cost to co-pays of other SGLT2 inhibitors. And confirm that they’re willing to use an online pharmacy.

For instance, patients will usually need to set up an account first. And online pharmacies may not have a patient’s complete med help identify and manage drug interactions.

If your patient gets bexagliflozin from another pharmacy, add the med to their profile...and help your pharmacist look for potential problems.

For instance, taking bexagliflozin with another SGLT2 inhibitor may increase the risk of side effects (kidney issues, etc).

Expect patients who get bexagliflozin to report taking one 20 mg tablet po once daily in the morning...with or without food.

Provide a MedGuide if you dispense bexagliflozin inform patients about key SGLT2 inhibitor risks, such as nausea, vomiting, and genital yeast infections.

Remember to watch for look-alike/sound-alike errors with any SGLT2 inhibitor. Their generic names only differ by the first few letters...bexagliflozin, canagliflozin, sotagliflozin, etc.

Key References

  • Bexagliflozin Efficacy and Safety Trial (BEST) July 14, 2021. (Accessed August 18, 2023).
  • Halvorsen YD, Conery AL, Lock JP, et al. Bexagliflozin as an adjunct to metformin for the treatment of type 2 diabetes in adults: A 24-week, randomized, double-blind, placebo-controlled trial. Diabetes Obes Metab. 2023 Jul 6. doi: 10.1111/dom.15192.
  • Allegretti AS, Zhang W, Zhou W, et al. Safety and Effectiveness of Bexagliflozin in Patients With Type 2 Diabetes Mellitus and Stage 3a/3b CKD. Am J Kidney Dis. 2019 Sep;74(3):328-337.
  • Medication pricing by Elsevier, accessed Aug 2023.
Pharmacy Technician's Letter. September 2023, No. 390904

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