Vol. 6 No. 8 (2026): August
Reimbursement Recommendations

Empagliflozin

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Published August 11, 2026

Key Messages

  • The Formulary Management Expert Committee (FMEC) recommends that empagliflozin be reimbursed for the treatment of chronic kidney disease (CKD) in adult patients with or without type 2 diabetes mellitus (T2DM), provided certain conditions are met.
  • Empagliflozin should be priced no higher than the least costly SGLT2 inhibitor available for this population.
  • FMEC reviewed 2 phase III randomized controlled trials (RCTs) (EMPA-KIDNEY and EMPA-REG RENAL) comparing empagliflozin with placebo in adults with CKD, 3 phase III RCTs that enrolled subgroups of adults with CKD (EMPA-REG OUTCOME, EMPEROR-Preserved, and EMPEROR-Reduced), 3 indirect treatment comparisons, and a cost comparison of empagliflozin versus other treatments used in Canada. Empagliflozin delayed time to progression of kidney disease or cardiovascular death (composite outcome) and delayed time to hospitalization for any cause. Empagliflozin was associated with delayed time to kidney disease progression (composite), delayed time to kidney disease progression or death from any cause (composite), delayed time to end-stage kidney disease (ESKD) or cardiovascular death (composite), and a slower decline in estimated glomerular filtration rate (eGFR).
  • FMEC concluded that empagliflozin demonstrates acceptable clinical value; the reimbursement conditions were further developed based on unmet need, distinct social and ethical considerations, and economic considerations.