The best value preferred sodium-glucose cotransporter-2 inhibitor (SGLT2i).
Dapagliflozin is the best value, preferred SGLT2i in Dorset. In line with NHSE recommendations, PCN teams are asked to ensure that dapagliflozin accounts for 92% of all SGLT2i prescribed in primary care, considering clinical appropriateness.
Switching is required by the 30th September 2026.
- Generic dapagliflozin is now available in the UK and is better value than other SGLT2i agents
- NICE considers all SGLT2i to have comparable clinical efficacy and safety profiles. Adoption of best-value agents allows space for promotion of optimum health outcomes whilst improving cost-effectiveness across the system
- Switching to dapagliflozin will help PCN teams care for patients within their NHS England financial envelope and hence, release funds to improve unmet needs in prevention
Discuss with local pharmacies, the intention to switch patients to dapagliflozin.
Run the SystmOne searches provided to identify patients prescribed a SGLT2i other than dapagliflozin:
Dorset SystmOne GPs>PINH 26 27> 1c Work to do: SGLT2i RPT switch to dapagliflozin
A risk management approach should be taken to any batch-switching arrangement, which includes safeguards which enable patients to have a review, should they have any queries or changes to their condition.
Exclusion criteria:
- <18 years of age
- Previous intolerance or allergy to dapagliflozin or its excipients
- Contraindication to dapagliflozin
- Lack of benefit from prior dapagliflozin use
- eGFR < 15 mL/min/1.73 m²
- Pregnancy and breastfeeding
Special considerations:
When making any change to a medication, please ensure:
- any potential drug interactions, cautions and contraindications are considered
- all relevant clinical monitoring parameters have been taken in the last 12 months and reviewed: note poorly controlled diabetes which should be highlighted for review
- any necessary dose adjustments have been made: note a lower initiation dose for dapagliflozin is required in severe hepatic impairment and dapagliflozin should be avoided is eGFR < 15ml/minute/1.73 m2
- any necessary follow up tests / appointments have been booked
Where clinically appropriate, after a shared decision-making process with patients, switch patient to dapagliflozin.
How to communicate this to patients:
Use the template patient text message and letter in SystmOne to notify patients of the change. Ensure patient is counselled appropriately.
SystmOne search to identify people potentially eligible for switch:
Dorset SystmOne GPs>PINH 26 27> 1c Work to do: SGLT2i RPT switch to dapagliflozin
Patient text message:
"NHS Dorset has asked GP teams to review prescriptions for canagliflozin, empagliflozin or ertugliflozin and change to dapagliflozin tablets, which is the NHS England preferred medicine in this class. Dapagliflozin offers the same effect and safety as your current prescription. Please read the label and patient information leaflet before starting this new medication and finish your old supply first. If you have any questions about this change, please ask your Community Pharmacist about a New Medicines Service Review."
Dapagliflozin template patient letter
References:
Overview | Dapagliflozin for treating chronic kidney disease | Guidance | NICE
Tracking achievement:
Numerator divided by Denominator from SystmOne searches x 100 for %
