Understanding ELIQUIS and Its Costs
ELIQUIS (apixaban) is a prescription anticoagulant (blood thinner) used to reduce the risk of stroke and blood clots in people with atrial fibrillation (AFib) not caused by a heart valve problem. It is also used to treat and prevent deep vein thrombosis (DVT) and pulmonary embolism (PE). While effective, its high cost can be a significant financial burden for many patients, with average retail prices often quoted at several hundred dollars for a month's supply.
The Primary Pathway: The ELIQUIS $10 Co-Pay Card
The most direct way to achieve the $10 per month price point is through the co-pay card offered by the drug's manufacturers, Bristol Myers Squibb and Pfizer. This program is specifically for patients with commercial insurance.
Eligibility Requirements: To qualify for the ELIQUIS Co-Pay Card, you must be a US resident aged 18 or older with commercial insurance that covers a portion of the drug's cost. Your co-pay must exceed $10, and you cannot be enrolled in any state or federal government healthcare programs such as Medicare, Medicaid, or VA benefits.
Program Terms: Eligible patients can pay as little as $10 for a 30-day supply, with a maximum annual benefit of $6,400. The benefit is available for up to 24 months, after which re-enrollment may be possible. The card requires activation before use and must be presented at a participating pharmacy with a valid prescription.
Financial Assistance for Other Patient Groups
If you are not eligible for the co-pay card due to being uninsured or having government insurance like Medicare, other programs can provide substantial financial relief.
For Uninsured Patients: Bristol Myers Squibb Patient Assistance Foundation (BMSPAF)
BMSPAF is a non-profit organization offering free ELIQUIS to eligible uninsured patients facing financial hardship. Eligibility is typically based on household income relative to the Federal Poverty Level, with some sources indicating an income limit around $46,950 for a single person. Applications can be submitted via the BMSPAF website or phone.
For Medicare Patients
While Medicare patients are ineligible for the manufacturer's co-pay card, they have alternative cost-saving options:
- Medicare Extra Help (LIS): This federal program assists low-income Medicare beneficiaries with prescription drug plan costs, including premiums, deductibles, and co-pays. Extra Help can reduce the cost of brand-name drugs like ELIQUIS to a small, fixed co-pay, potentially $11.20 or $12.15 in 2025.
- Medicare Part D Plan Selection: ELIQUIS costs vary significantly between different Part D plans. Comparing plans during open enrollment based on their coverage and costs for ELIQUIS is important. The manufacturer reports an average co-pay of about $54 per month for Medicare patients.
Other Cost-Saving Strategies
- Prescription Discount Cards: Services like GoodRx and SingleCare offer discounts off the retail price, useful for cash-paying customers. These cannot be combined with insurance, but the discounted price might be lower than an insurance co-pay in some cases. SingleCare suggests a potential price around $488 with their coupon.
- 90-Day Supplies: Many insurance plans, including Medicare Part D, offer lower costs for a 90-day supply obtained through mail order compared to a 30-day retail pharmacy supply.
- Independent Foundations: Charitable foundations such as the HealthWell Foundation may provide grants to help underinsured patients, including those with Medicare, cover out-of-pocket medication expenses.
Savings Program Comparison
Program/Method | Eligible Patients | Potential Monthly Cost | Key Limitation |
---|---|---|---|
ELIQUIS Co-Pay Card | Commercially insured | As low as $10 | Cannot be used with government insurance (Medicare, Medicaid). |
BMS Patient Assistance | Uninsured, financial hardship | $0 | Must meet specific household income requirements. |
Medicare Extra Help (LIS) | Medicare recipients with low income/resources | $0 - $12.15 | Must qualify based on income and asset limits. |
Prescription Discount Card | Primarily for cash-paying customers | Varies; can be >$400 | Cannot be combined with insurance; discount varies by pharmacy. |
Alternatives to ELIQUIS
Discussing any potential medication changes with a healthcare provider is essential. While a generic version of ELIQUIS (apixaban) has received FDA approval, patent issues may delay its general availability until 2026 or later.
Common alternatives include:
- Xarelto (rivaroxaban): A Factor Xa inhibitor, often taken once daily.
- Pradaxa (dabigatran): A direct thrombin inhibitor.
- Warfarin (Coumadin): An older, less expensive generic anticoagulant requiring regular blood monitoring (INR tests) and having dietary interactions.
Conclusion
For commercially insured patients, using the manufacturer's Co-Pay Card is the primary method for how to get ELIQUIS for $10 per month. Individuals with Medicare or no insurance have viable options through programs like Medicare Extra Help and the Bristol Myers Squibb Patient Assistance Foundation. Exploring these resources and consulting with a healthcare provider can significantly ease the financial burden of this important medication.
For additional details on manufacturer savings programs, visit the official ELIQUIS website.