Why Is Eliquis So Expensive? 5 Key Reasons & How to Save

If you've ever experienced sticker shock at the pharmacy counter when picking up your Eliquis prescription, you're not alone. With a retail price that can soar above $600 for a 30-day supply, this vital blood thinner is a significant financial burden for many. This article breaks down the complex reasons behind Eliquis's high price tag and, more importantly, provides a comprehensive guide on how you can reduce your costs.

What is Eliquis and Why is it Prescribed?

Eliquis (generic name: apixaban) is a life-saving medication known as an anticoagulant, or blood thinner. It belongs to a class of drugs called direct oral anticoagulants (DOACs). Doctors prescribe it to:

• Reduce the risk of stroke in patients with non-valvular atrial fibrillation (AFib), a common type of irregular heartbeat.
• Treat and prevent deep vein thrombosis (DVT), which are blood clots in the legs.
• Treat and prevent pulmonary embolism (PE), which are blood clots in the lungs.
• Prevent DVT in patients who have undergone hip or knee replacement surgery.

Eliquis is often preferred over older anticoagulants like warfarin because it generally requires less frequent blood monitoring and has fewer dietary restrictions, offering patients a higher quality of life. However, this convenience comes at a steep price.

Eliquis pills in a prescription bottle Image from Unsplash, by Myriam Zilles

The Core Reasons Behind Eliquis's High Price Tag

The cost of Eliquis isn't arbitrary. It's the result of a complex mix of pharmaceutical economics, patent law, and the unique structure of the U.S. healthcare system.

Monopoly Power: Patent Protection and Market Exclusivity

The single biggest reason for Eliquis's high cost is patent protection. When Bristol Myers Squibb and Pfizer developed Eliquis, they were granted patents that give them the exclusive right to manufacture and sell the drug in the U.S. This government-sanctioned monopoly prevents other companies from producing a cheaper, generic version.

According to Optum Perks, this patent was originally set to expire sooner, but legal challenges and additional patents have extended the manufacturers' exclusive rights. As a result, a generic version of apixaban, though approved by the FDA, is not expected to be available in the U.S. until at least 2026. Without competition, the manufacturers can set the price as high as the market will bear.

The R&D Investment vs. Profit Debate

Pharmaceutical companies justify high prices by pointing to the enormous costs of research and development (R&D). Bringing a new drug to market is a decade-long, billion-dollar process involving research, extensive clinical trials for safety and effectiveness, and navigating the FDA approval process. Companies argue that high prices during the patent period are necessary to recoup these investments and fund future innovation.

However, critics and patient advocacy groups, like Patients For Affordable Drugs, argue that prices are driven more by profit motives. Eliquis is a "blockbuster" drug, generating billions in revenue annually. Reports suggest that pharmaceutical companies often spend more on marketing and stock buybacks than on R&D, leading to a debate about whether prices reflect true innovation costs or a desire for maximum profit.

The U.S. Pricing System

Unlike most other developed nations, the United States government does not directly negotiate or regulate the prices of prescription drugs for the general population. As noted by BuzzRx, this allows pharmaceutical companies to set much higher prices in the U.S. than they do elsewhere.

A report from Reuters highlighted the staggering price difference: a month's supply of Eliquis that costs over $600 in America can be purchased for as little as $114 in Sweden or $20 in Japan. This disparity is a direct result of the U.S. system, which relies on private insurance negotiations rather than government price controls.

A Newer, More Convenient Anticoagulant

Part of the cost is also tied to the drug's effectiveness and convenience. Compared to the older, generic standard Warfarin, Eliquis is seen as a superior product by many doctors and patients. This high demand, combined with its protected brand status, contributes to its premium price.

A Glimmer of Hope: Government Negotiations and Generic Availability

Fortunately, the landscape is beginning to shift, with changes on the horizon that promise to make Eliquis more affordable.

The Inflation Reduction Act's Impact

For the first time in U.S. history, the federal government is negotiating drug prices for Medicare recipients, thanks to the Inflation Reduction Act of 2022. Eliquis was one of the first 10 drugs selected for this negotiation. According to KFF (Kaiser Family Foundation), the negotiated price for Medicare will be significantly lower, though these new prices won't take effect until 2026. While this initially only benefits Medicare patients, it sets a powerful precedent for future drug pricing.

When Will Generic Eliquis (Apixaban) Be Available?

The eventual arrival of generic apixaban is the most anticipated factor for price reduction. Once the patents for Eliquis expire and generic versions enter the market, competition will drive prices down dramatically for all patients. As mentioned, the current timeline points to a generic release between 2026 and 2028.

How to Reduce Your Eliquis Costs Today: A Patient's Guide

Waiting for 2026 is not an option for most patients. Thankfully, there are several strategies you can use right now to lower your out-of-pocket costs for Eliquis.

Manufacturer and Patient Assistance Programs

The makers of Eliquis offer several programs to help patients afford their medication.

• Eliquis Co-pay Card: If you have commercial insurance, you may be eligible for a co-pay card that can reduce your payment to as little as $10 per 30-day supply. You can check your eligibility on the official Eliquis website. Note that these cards are not for patients on government-funded plans like Medicare or Medicaid.
• 30-Day Free Trial: A free trial offer is often available for first-time users with a valid prescription.
• Bristol Myers Squibb Patient Assistance Foundation: For patients with no insurance or limited income, this foundation may be able to provide Eliquis at little to no cost.

Image from Pexels, by Tima Miroshnichenko

Using Insurance and Pharmacies Strategically

• Compare Medicare Part D Plans: If you are on Medicare, it is crucial to compare Part D plans each year during open enrollment. Plans have different formularies (lists of covered drugs) and cost-sharing structures. Choose a plan that covers Eliquis favorably.
• Ask for a 90-Day Supply: Many insurance plans offer a lower co-pay for a 90-day mail-order supply compared to a 30-day supply from a retail pharmacy.
• Use Preferred Pharmacies: Check with your insurance provider to see if they have a network of "preferred" pharmacies that offer lower prices.

Prescription Discount Cards

Services like GoodRx offer free coupons that can significantly reduce the retail price of Eliquis, which is especially helpful for those paying with cash or who have high-deductible insurance plans. Always compare the coupon price to your insurance co-pay to see which is cheaper.

Exploring Cheaper Alternatives to Eliquis

If the cost of Eliquis remains prohibitive, discuss potential alternatives with your doctor.

Warfarin (Coumadin): The Low-Cost Standard

Warfarin is an older anticoagulant that is widely available as a cheap generic. For decades, it was the go-to blood thinner. However, it has significant drawbacks:

• Requires frequent blood tests (INR monitoring) to ensure the dose is correct.
• Has numerous interactions with food (especially those high in Vitamin K, like leafy greens) and other medications.

While less convenient, it is a highly effective and affordable option for many.

Other Brand-Name Anticoagulants

Other DOACs like Xarelto (rivaroxaban) and Pradaxa (dabigatran) work similarly to Eliquis. However, as they are also brand-name drugs, they may not offer significant cost savings. Your insurance plan might cover one of these drugs more favorably than Eliquis, so it's worth checking.

The Importance of Consulting Your Doctor

Disclaimer: Never stop taking Eliquis or switch to an alternative medication without first consulting your healthcare provider. Abruptly stopping an anticoagulant can significantly increase your risk of a stroke or blood clot. Your doctor can help you weigh the risks and benefits of each option based on your specific medical condition and financial situation.

Frequently Asked Questions (FAQ)

Why is Eliquis so expensive?

Eliquis is expensive primarily because it is a brand-name drug still under patent protection, which prevents cheaper generic versions from entering the U.S. market. This monopoly allows the manufacturers, Bristol Myers Squibb and Pfizer, to set high prices to recoup significant research and development (R&D) costs and maximize profits. The U.S. healthcare system's lack of direct government price regulation further contributes to its high cost compared to other countries.

When will a generic version of Eliquis be available?

While the FDA has approved generic versions of Eliquis (apixaban), they are not yet available to consumers in the United States due to ongoing patent protection and legal agreements. The generic version is not expected to be available until at least 2026, and possibly as late as 2028, depending on the outcome of patent litigations.

What is the cheapest way to get Eliquis?

The cheapest ways to get Eliquis involve using manufacturer savings programs and discount cards. If you have commercial insurance, the Eliquis Co-Pay Card can lower your cost to as little as $10 for a 30-day supply. For those without insurance or with limited income, the Bristol Myers Squibb Patient Assistance Foundation may provide the medication for free. Additionally, prescription discount services like GoodRx can offer significant savings off the retail price.

What is a cheaper substitute for Eliquis?

Yes, the most common and significantly cheaper alternative to Eliquis is Warfarin (Coumadin). Warfarin is an older anticoagulant available as a low-cost generic. However, it requires frequent blood monitoring and dietary restrictions. Other modern anticoagulants like Xarelto and Pradaxa exist, but they are also brand-name drugs and may not offer substantial cost savings. Always consult your doctor before considering a switch in medication.

References

• Optum Perks: Why is Eliquis so expensive?
• Medical News Today: Eliquis cost 2025: Savings tips and more
• BuzzRx: Why Is Eliquis So Expensive?
• KFF: Eliquis's New Lower Direct-to-Consumer Price is Still Higher Than Medicare's Negotiated Price
• Patients For Affordable Drugs: Eliquis and Xarelto Report
• Eliquis Official Website: Savings and FTO