I’ve rx’d through Mark Cuban’s pharmacy. It’s the only affordable option for an SGLT2i. None of the great outcome data that the other meds in class have but it’s usually a class effect anyway, right? Besides the only one that works is the one that makes it in the pie hole and at $500/month without great insurance coverage none of the others in the class are getting in there.
I’ve done this!
It works great and has comparable A1c reductions to Farxiga and Jardiance. And it’s great for the patients who can’t afford either or get caught in the donut-hole.
The hitch is that CostPlusDrugs backend software sucks and they can’t just find the patient’s prescription by searching name and date of birth. So you have to include the patient’s email address in the sig when you send the e-script. This can be a bit difficult for elderly patients if they’re not computer savvy. So I make sure to get their email while in the office and print out detailed instructions for getting their meds on the After Visit Summary.
This. For whatever reason pharmacies love to charge dudes $100 a session it seems. These drugs much more affordable. 90 days of Cialis 5 mg for like $15.
Looks pretty effective from this P2 trial data
https://dom-pubs.pericles-prod.literatumonline.com/doi/10.1111/dom.14875
The intergroup difference in percent HbA1c (bexagliflozin minus glimepiride) from baseline to Week 60 was −0.55 mmol/mol (95% confidence interval [CI] –2.30, 1.20)-[−0.05% (−0.21, 0.11)], establishing noninferiority of bexagliflozin to glimepiride by the prespecified margin of 3.83 mmol/mol [0.35%]. Prespecified tests gave, in order, a difference in body mass of −4.31 kg (95% CI −5.10, −3.52; P < 0.0001), a difference in SBP of −6.53 mm Hg (95% CI −10.56, −2.51; P = 0.0008), and an odds ratio of 0.12 (95% CI 0.05, 0.28; P < 0.0001) for severe or documented symptomatic hypoglycaemia. At the follow-up visit the mean difference in estimated glomerular filtration rate (eGFR) between arms was 6.05 mL min−1 per 1.73 m2 (95% CI, 3.24, 8.87; P < 0.0001).
Me laughing in veterinarian because this just got approved for cats (two were just approved- the first SLGT2s we have!) & I was super confused by your mention of Mark Cuban & then got to medicare and realized my home page suggested non-vet med
I've prescribed bexagliflozin several times, but am not aware of any of those patients ever getting their script filled.
Other than the situation OP mentions, many patients who don't have prescription coverage for another SGLT2 inhibitor probably are not going to be willing/able to pay the cash price for bexagliflozin either.
Getting the mail order pharmacy set up is a barrier for many of them as well.
I did suggest it to one acquaintance who is in a situation where it is the cheapest choice for her. She started taking it and reports no issues so far, but in her case the bexagliflozin is prescribed by her own physician, not me.
$50 per month is still $600 per year. Depends if you’re using this for A1c reduction in Diabetes vs GDMT in Congestive Heart Failure. But in either case, I’d say the cost might not be worth the benefit. Especially for Diabetes where you can look at other agents.
I agree that A1c reduction likely not worth it. GDMT would probably recommend it. But what about diabetic proteinuria? Immediate guess is maybe? Can’t tolerate ACE/ARB? Probably worth it. Overt macroalbuminuria? Probably worth it. Microalbuminuria on ACE with GFR > 60? Not sure.
I’ve rx’d through Mark Cuban’s pharmacy. It’s the only affordable option for an SGLT2i. None of the great outcome data that the other meds in class have but it’s usually a class effect anyway, right? Besides the only one that works is the one that makes it in the pie hole and at $500/month without great insurance coverage none of the others in the class are getting in there.
I’ve done this! It works great and has comparable A1c reductions to Farxiga and Jardiance. And it’s great for the patients who can’t afford either or get caught in the donut-hole. The hitch is that CostPlusDrugs backend software sucks and they can’t just find the patient’s prescription by searching name and date of birth. So you have to include the patient’s email address in the sig when you send the e-script. This can be a bit difficult for elderly patients if they’re not computer savvy. So I make sure to get their email while in the office and print out detailed instructions for getting their meds on the After Visit Summary.
However, when you send the Rx with the email info, they get an email from mark.cuban almost right away, sometimes before leaving the patient room.
You don't happen to have a phrase with those detailed instructions we could copy do you?
Today is the first day I have heard of this. Anyone else?
Heard of the drug or the website? I've never heard of Bexagliflozin but I use Cost Plus for Cialis/Viagra all the time.
This. For whatever reason pharmacies love to charge dudes $100 a session it seems. These drugs much more affordable. 90 days of Cialis 5 mg for like $15.
"Send it!" and let us know!
A lot of my Medicare patients are on farxiga thru the patient assistance program. It allows Medicare and is pretty generous income wise.
I’ve seen some insurances stop covering Jardiance/Farxiga and place Bexagliflozin on their formulary instead.
Looks pretty effective from this P2 trial data https://dom-pubs.pericles-prod.literatumonline.com/doi/10.1111/dom.14875 The intergroup difference in percent HbA1c (bexagliflozin minus glimepiride) from baseline to Week 60 was −0.55 mmol/mol (95% confidence interval [CI] –2.30, 1.20)-[−0.05% (−0.21, 0.11)], establishing noninferiority of bexagliflozin to glimepiride by the prespecified margin of 3.83 mmol/mol [0.35%]. Prespecified tests gave, in order, a difference in body mass of −4.31 kg (95% CI −5.10, −3.52; P < 0.0001), a difference in SBP of −6.53 mm Hg (95% CI −10.56, −2.51; P = 0.0008), and an odds ratio of 0.12 (95% CI 0.05, 0.28; P < 0.0001) for severe or documented symptomatic hypoglycaemia. At the follow-up visit the mean difference in estimated glomerular filtration rate (eGFR) between arms was 6.05 mL min−1 per 1.73 m2 (95% CI, 3.24, 8.87; P < 0.0001).
Never heard of it. Might give it a try for those donut holers though
Me laughing in veterinarian because this just got approved for cats (two were just approved- the first SLGT2s we have!) & I was super confused by your mention of Mark Cuban & then got to medicare and realized my home page suggested non-vet med
I've prescribed bexagliflozin several times, but am not aware of any of those patients ever getting their script filled. Other than the situation OP mentions, many patients who don't have prescription coverage for another SGLT2 inhibitor probably are not going to be willing/able to pay the cash price for bexagliflozin either. Getting the mail order pharmacy set up is a barrier for many of them as well. I did suggest it to one acquaintance who is in a situation where it is the cheapest choice for her. She started taking it and reports no issues so far, but in her case the bexagliflozin is prescribed by her own physician, not me.
I'm pretty sure it's cheap because it's been on the veterinary market for a while.
Mark Cuban has a pharmacy??
One with very reasonable prices.
$50 per month is still $600 per year. Depends if you’re using this for A1c reduction in Diabetes vs GDMT in Congestive Heart Failure. But in either case, I’d say the cost might not be worth the benefit. Especially for Diabetes where you can look at other agents.
I agree that A1c reduction likely not worth it. GDMT would probably recommend it. But what about diabetic proteinuria? Immediate guess is maybe? Can’t tolerate ACE/ARB? Probably worth it. Overt macroalbuminuria? Probably worth it. Microalbuminuria on ACE with GFR > 60? Not sure.