Formulary changes are script for cost savings at Lutheran

As we continue to review therapeutic interchanges to harmonize the Enterprise Intermountain Health Formulary, most recently we switched from empagliflozin to dapagliflozin as the choice SGLT-2 inhibitor.

Peaks historically added empagliflozin to formulary, largely in part due to the KP formulary, and restricted its use to heart failure in the acute setting. Enterprise is making dapagliflozin the formulary agent (making empagliflozin nonformulary) for a few reasons listed below:

• Dapagliflozin has similar safety and efficacy as other SGLT-2 inhibitors.

• Dapagliflozin is labeled to prevent progression of CKD and HFrEF/HFpEF in patients with or without T2DM.

• Mortality benefit for HF seen in clinical trials

• Cost savings:

Dapagliflozin also has a generic available.

Lutheran will carry the dapagliflozin 10 mg tablet, which is the studied dose in clinical trials. We will open the ordering indications to include T2DM and CKD, which will align with several clinical practice guidelines, including AACE, ADA, AHA/ACC/HFSA and KDIGO. Pharmacy will switch to dapagliflozin when we are out of empagliflozin stock, which we anticipate before the end of the first week of November.

Please contact Pharmacy with any questions. Thank you for your thoughtful care of your patients.