Understanding the High Cost of Brand-Name Eliquis
Eliquis, a direct oral anticoagulant (DOAC) used to prevent and treat blood clots, has a high retail price largely because it is a brand-name drug with a protected patent. While FDA-approved generic versions of the active ingredient, apixaban, exist, patent litigation may delay their market availability until 2026 or later. When generics become available, costs are expected to decrease significantly. Currently, the final cost for patients varies based on insurance, dosage, and pharmacy.
Leveraging Manufacturer Savings Programs
Manufacturer Bristol-Myers Squibb (BMS) offers programs to help reduce costs:
- Eliquis Co-pay Card: This card can lower the monthly co-pay for eligible commercially insured patients to as little as $10. It is not available to those in government programs like Medicare or Medicaid.
- Free Trial Offer: New patients can receive a free 30-day supply of Eliquis.
- Bristol Myers Squibb Patient Assistance Foundation (BMSPAF): This program offers free medication to eligible uninsured patients with financial difficulties, based on income and residency.
Using Prescription Discount Cards and Coupons
Discount cards provide savings off the retail price, particularly for uninsured individuals or those with high deductibles. They cannot be combined with insurance for a single purchase.
- SingleCare: Using a SingleCare coupon can significantly reduce the price of Eliquis.
- GoodRx: GoodRx offers free coupons for discounts on Eliquis at many pharmacies. Their platform allows comparing prices at local and mail-order pharmacies.
- Optum Perks: This service also provides coupons to help lower the cost of Eliquis.
Navigating Government Healthcare Programs
Government programs offer various forms of assistance:
- Medicare Part D and Medicare Advantage (Part C): Most Medicare prescription drug plans cover Eliquis, with costs varying by plan. The Inflation Reduction Act is expected to lead to lower costs for beneficiaries starting in 2026 through price negotiation.
- Medicare Extra Help (Low-Income Subsidy): Low-income Medicare beneficiaries can receive Extra Help to significantly lower prescription costs. In 2025, qualified individuals might pay between $0 and $12.15 per month for Eliquis.
- Medicaid: Many state Medicaid programs cover Eliquis, often with low or no copayments, depending on the state's formulary.
- State Pharmaceutical Assistance Programs (SPAPs): Some states offer additional assistance for prescription costs not covered by Medicare or Medicaid.
Comparison of Eliquis Savings Methods
| Savings Method | Best For | Typical Cost Reduction | Eligibility Requirements | Cannot Be Combined With | Key Advantages |
|---|---|---|---|---|---|
| Manufacturer Co-pay Card | Commercially insured patients with high co-pays | As low as $10 monthly | Commercial insurance, not government programs | Medicare, Medicaid, etc. | Offers a very low and predictable monthly cost. |
| Patient Assistance Programs (BMSPAF) | Uninsured or underinsured with low income | Little to no cost | Uninsured, low income, financial hardship | Any other discount or program | Can provide Eliquis for free for qualified individuals. |
| Prescription Discount Cards (GoodRx, SingleCare) | Uninsured or underinsured patients | Substantial savings off retail price | No requirements (can't be combined with insurance) | Health insurance, Medicare | Easy to use and provides instant savings; no enrollment needed. |
| Medicare Extra Help | Low-income Medicare beneficiaries | Extremely low co-pay ($0-$12.15) | Low income and resources | Other discounts | Can virtually eliminate out-of-pocket costs for qualified seniors. |
| Pharmacy Shopping / 90-Day Supply | All patients | Varies; can reduce overall spending | None | Varies (check with pharmacy/plan) | Simple way to find the lowest local price; fewer trips to the pharmacy. |
Additional Pharmacy Savings and Future Considerations
Other ways to reduce costs include:
- Compare Pharmacy Prices: Prices can vary significantly between pharmacies. Tools like GoodRx or SingleCare help compare costs.
- Opt for a 90-Day Supply: Many plans and mail-order pharmacies offer lower co-pays for a 90-day supply.
- Mail-Order Pharmacies: Using your insurance plan's mail-order option can often provide lower costs and convenience.
- The Upcoming Generic: The eventual launch of generic apixaban is expected to lower costs for all consumers, though its availability has been delayed.
Conclusion
Despite the high list price of Eliquis, various options exist to significantly reduce your out-of-pocket expenses. The most affordable method depends on your individual circumstances, including your insurance coverage and income. Manufacturer co-pay cards are beneficial for those with commercial insurance. Low-income individuals may find relief through government programs like Medicare Extra Help or the BMS Patient Assistance Foundation. Comparing prices with discount cards and utilizing 90-day supplies offer additional savings for many. It's important to actively explore all available resources to ensure access to this necessary medication. Consulting your doctor and pharmacist can help determine the best strategy for your situation.
