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Inpefa (sotagliflozin) is in the SGLT inhibitor class recommended as first-line treatment for heart failure by the American Heart Association and other groups. Jardiance (empaglifozin), a competitor in that class, has a list price of $570.48 for a month's supply.

JAMA Internal Medicine editor and a UCSF colleague wrote in a New England Journ of Medicine opinion piece that the decision highlights the need to establish a new requirement that would make coverage decisions contingent on evidence of benefit for Medicare population.

Interviews with 32 patients shows a wide range of experiences but authors say one takeaway is a need for better coordination between HCM specialist and community cardiologists.