SGLT-2
11+ years of ground truth.
From diabetes drug to cardiovascular cornerstone — here's what IMX Data sees.
Press arrow keys, space, or Enter to advance
Launched 2013 for Type 2 Diabetes. Heart Failure (2020–2023) and Chronic Kidney Disease approvals followed; the chart shows market claims grew +459% from 2015 to 2025.
EMPA-REG OUTCOME, DAPA-HF, EMPEROR-Preserved — each trial readout drove a visible IMX claim-volume acceleration within quarters.
AstraZeneca authorized generic launched Jan 2024. Independent generics arrived 2026 post late-2025 patent expiry. 1.4% of all-time SGLT-2i claims.
The SGLT-2 inhibitor market grew +459% from our 2015 baseline to 2025 — from 3.9M annual claims to 21.7M. The 2018 growth slowdown is visible in the chart above.
IMX Data captures this trajectory in daily claims — drug by drug, payer by payer, indication by indication.
All-time totals (2015–2025): 116M total claims · $126B cumulative market revenue. Data covers USC class codes 39311 (SGLT2), 39312 (SGLT2/biguanide), 39313 (SGLT2/DPP-4), and sotagliflozin (Inpefa).
Annual revenue grew from $2B in 2015 to $32B in 2025. The 2018 growth slowdown is visible in the trajectory above, followed by a sustained post-2019 acceleration.
The signal: The 2018 growth slowdown and post-2019 re-acceleration shown in this revenue trajectory are derived from the same daily IMX claim-level data.
Invokana led until the May 2017 CANVAS warning; Jardiance overtook within months. Dapagliflozin generic appears late 2023 (AstraZeneca authorized generic, Jan 2024). Independent generics arrive 2026 after the late-2025 patent expiry.
The signal: Invokana's ~32% 2017→2018 decline is visible in monthly IMX data.
IMX measures U.S. pharmacy demand. AstraZeneca measures U.S. net revenue. Different lenses on the same market — and they move together. Farxiga's unique-patient growth in IMX tracks AstraZeneca's reported U.S. Farxiga revenue growth within ~1 percentage point: a saturated franchise at the late-2025 patent expiry, signaled the same way through both lenses.
IMX U.S. unique-patient growth vs. manufacturer-reported U.S. net revenue growth · 2024 → 2025
Why patient counts, not gross spend: IMX gross pharmacy spend grew +37.4% from 2024 to 2025 because per-claim spend rose ~23% — patients shifting from 30-day to 90-day fills inflates dollars without changing real demand. Unique patient counts strip out that distortion. Jardiance, Invokana, and Inpefa are excluded from this comparison: Jardiance because Lilly only recognizes a royalty share as revenue and Boehringer Ingelheim doesn't disclose the U.S. portion; Invokana because J&J doesn't separately disclose U.S. canagliflozin; and Inpefa because Lexicon significantly reduced commercial promotion in 2025 after licensing rights outside the U.S. and Europe — distorting the reported revenue trend.
IMX aggregates, normalizes, and delivers U.S. pharmaceutical and medical claims at a depth built for financial analysis — drug-level, indication-level, payer-level, and daily.
2015 through 2025. Every trial readout, every FDA approval, every formulary change — visible in IMX claim volume before it becomes consensus.
Jardiance vs. Farxiga vs. Invokana — claims, spend, and market share by brand, molecule, and manufacturer. Watch generic erosion as it happens.
Prior auth rejection rates, plan limit rates (step therapy, quantity caps, days-supply caps), and plan-type breakdowns — identify where access is tightening before it affects earnings reports.
Track the slow expansion from Type 2 Diabetes-only into Heart Failure and Chronic Kidney Disease as cardiovascular indications mature.
IMX cross-references SGLT-2i pharmacy fills against every diagnosis on a patient's medical claims plus the diagnosis on the prescription itself. Each matched patient is assigned a single primary indication via clinical hierarchy: Type 2 Diabetes first, then Heart Failure, then Chronic Kidney Disease-only.
Family Medicine and Internal Medicine write nearly half of all SGLT-2i Rx — mostly diabetic. Cardiology: 72% of 1.7M claims are non-diabetic.
The cardiologist signal: 72% of Cardiology's 1.7M SGLT-2i claims go to non-diabetic patients.
The 55–64 and 65–74 age bands carry the highest SGLT-2i patient volume in the chart above.
Female patients represent 43% of unique SGLT-2i users; male patients represent 57%.
IMX tracks 7.4M unique Chronic Kidney Disease patients across six groups, with SGLT-2i rates ranging from 3.1% (Chronic Kidney Disease-only) to 19.2% (triple-comorbidity).
SGLT-2i utilization rate by Chronic Kidney Disease comorbidity subgroup · 2025 · IMX Data
| Subgroup | IMX Patients | IMX SGLT-2i % |
|---|---|---|
| Chronic Kidney Disease Overall (rollup) | 7.4M | 10.2% |
| Chronic Kidney Disease Stage 3-5 (rollup) | 4.9M | 11.9% |
| Chronic Kidney Disease Only | 3.2M | 3.1% |
| Chronic Kidney Disease + Type 2 Diabetes | 2.3M | 16.2% |
| Chronic Kidney Disease + Heart Failure | 0.8M | 10.0% |
| Chronic Kidney Disease + Type 2 Diabetes + Heart Failure | 1.0M | 19.2% |
IMX SGLT-2i % is the share of patients within each subgroup who filled at least one approved SGLT-2i prescription in 2025 — a utilization rate within the subgroup, not a share of total SGLT-2i prescribing.
California, Florida, New York, and Texas alone account for over 36% of total U.S. SGLT-2i volume.
Molecule vs. brand. The Molecule Battle sums every SKU sharing a generic name — Empagliflozin includes Jardiance, Synjardy, and Glyxambi; Dapagliflozin includes Farxiga, Xigduo, Qtern, and generic dapagliflozin. The Brand Claim Volume chart shows each drug separately, so “Dapagliflozin (G)” there is the generic SKU only — Farxiga is its own row.
Access friction varies by plan. Commercial and Employer plans show the highest prior auth and plan-limits rates. Medicare's prior-auth and plan-limits rates are the lowest in the table, but its absolute rejection volume is the largest.
Data: 2024–2025 rejected claims · IMX Data
Share of SGLT-2i submissions to each plan rejected with NCPDP code 75 (Prior Auth) or 76 (Plan Limits — step therapy, quantity caps, days-supply) in 2024–2025 — the two payer-side utilization-management codes. Other codes (e.g. Refill Too Soon) reflect pharmacy rules, not payer access.
Refill Too Soon (code 79) leads aggregate rejection volume. The Plan Limits Rate column reflects NCPDP code 76 (Plan Limitations Exceeded), which covers step therapy, quantity caps, and days-supply caps. Prior Auth Rate reflects NCPDP code 75.
IMX-derived projection. Applying the 6.4% per-patient spend growth rate (2020 → 2025) to the 2025 revenue base, the market reaches ~$63.3B by 2036. Solid line = IMX actuals. Dashed line = IMX-derived projection.
IMX Data delivers the depth behind the headlines.
Every drug · Every indication · Every day.