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Lexicon Pharmaceuticals’ Heart Failure Treatment Added to Express Scripts Formulary


Inpefa to be added on pharmacy benefit manager’s basic and high-performance formularies for commercially insured patients.

Heart And Bacteria or Bacterial Endocarditis and septicemia or sepsis as blood poisoning due to germs with 3D illustration elements. Image Credit: Adobe Stock Images/freshidea

Image Credit: Adobe Stock Images/freshidea

Lexicon Pharmaceuticals, Inc. announced that Express Scripts, the pharmacy benefit management (PBM) business of The Cigna Group's Evernorth, will be placing sotagliflozin (Inpefa) on its Basic and High Performance formularies for commercially insured patients. The addition comes after the previously reported news that the treatment will also be included on the Premier Access and Premier Performance national formularies for Medicare patients.1

As a once-daily oral tablet, sotagliflozin was approved by the FDA back in May for the treatment of heart failure to reduce the risk of cardiovascular death, hospitalization for heart failure, and urgent heart failure visit in adults with type 2 diabetes mellitus, chronic kidney disease, and other cardiovascular risk factors.1

“We continue to make progress in establishing access and reimbursement for Inpefa and are pleased by the Express Scripts decision announced today,” said Lonnel Coats, CEO, Lexicon Pharmaceuticals, in a company press release. “We continue to work toward our goal of broad access to and coverage for Inpefa, with this being the latest of a series of coverage decisions.”

Sotagliflozin is an inhibitor of both sodium-glucose co-transporter types 1 and 2 (SGLT1 and SGLT2). SGLT1 is responsible for facilitating glucose absorption in the gastrointestinal tract, whereas SGLT2 is the primary transporter involved in reabsorbing glucose in the glomerulus. Inhibiting SGLT1 leads to a delay in glucose absorption and a reduction in postprandial hyperglycemia. On the other end, SGLT2 decreases the renal reabsorption of filtered glucose, resulting in increased urinary glucose excretion.2,3

Heart disease is currently the leading cause of mortality for men and women, as well as people of most racial and ethnic groups in the United States. The CDC estimates that there is a new death every 33 seconds in the United States from cardiovascular disease and approximately 695,000 individuals in the United States died from the condition in 2021, which translates to 1 in every 5 deaths. The CDC estimates that heart disease cost the US healthcare system approximately $239.9 billion each year from 2018 to 2019, which includes the cost of health care services, medications, and lost productivity resulting from mortality.4

Currently, sotagliflozin is only commercially available in the United States.


1. INPEFA® (Sotagliflozin) Receives Coverage From Express Scripts on Its Basic and High Performance Formularies for Commercially Insured Patients. GlobeNewswire. November 1, 2023. Accessed November 2, 2023. https://www.globenewswire.com/news-release/2023/11/01/2771289/0/en/INPEFA-Sotagliflozin-Receives-Coverage-From-Express-Scripts-on-Its-Basic-and-High-Performance-Formularies-for-Commercially-Insured-Patients.html

2. Clinical Overview: Sotagliflozin (Inpefa) for Heart Failure. Pharmacy Times. October 27, 2023. Accessed November 2, 2023. https://www.pharmacytimes.com/view/clinical-overview-sotagliflozin-inpefa-for-heart-failure

3. Lapuerta P, Zambrowicz B, Strumph P, et al. Development of sotagliflozin, a dual sodium-dependent glucose transporter 1/2 inhibitor. Diab Vasc Dis Res. 2015 Mar;12(2):101-10. doi: 10.1177/1479164114563304.

4. Centers for Disease Control and Prevention. Heart Disease Facts. CDC. https://www.cdc.gov/heartdisease/facts.htm. Accessed November 2, 2023.

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