Eliquis

If you’ve ever been prescribed Eliquis, you may have experienced sticker shock at the pharmacy counter. As one of the most widely used blood thinners, Eliquis plays a crucial role in preventing strokes and blood clots. But its price can be staggering. Without insurance, a one-month supply can cost between $400 and $600, making it a financial burden for many Americans seeking care. But why is Eliquis so expensive? From patent protections and research costs to the lack of pricing regulations in the U.S., several factors contribute to its high price tag. In this article, we’ll break down the reasons behind the high cost of Eliquis and explore how you can save money on this essential medication.

What is Eliquis?

Eliquis, with the generic name apixaban, is an oral anticoagulant (blood thinner) that belongs to the drug class of Factor Xa inhibitors. It works by blocking Factor Xa, a protein necessary for blood clotting, thereby reducing the formation of clots in the blood.

What is Eliquis Used for?

Eliquis is used to reduce the risk of stroke and blood clots in people who have atrial fibrillation. It reduces the risk of forming a blood clot in the legs and lungs of people who have just had hip or knee replacement surgery. Eliquis treats blood clots in the veins of your legs (deep vein thrombosis) or lungs (pulmonary embolism), and reduces the risk of them occurring again. 

How Much Does Eliquis Cost?

Without insurance, Eliquis may cost between $400 – $600 for a 30-day supply, depending on dosage and pharmacy location. Medicare and insurance plans may reduce costs significantly, but out-of-pocket expenses vary based on the coverage.

Is Eliquis The Most Expensive Blood Thinner?

Eliquis is among the most expensive blood thinners on the market, but it is not the absolute costliest. Blood thinners, also known as anticoagulants, are essential medications for preventing strokes, blood clots, and other cardiovascular complications. However, their pricing varies significantly depending on the brand, availability of generics, and insurance coverage.

As of 2024, the average retail price for a 30-day supply of Eliquis (5 mg, 60 tablets) in the U.S. is around $642, translating to about $10.70 per tablet. For a 168-tablet supply, the cost exceeds $1,765.52. This makes Eliquis one of the priciest options, particularly for those without insurance. Compared to older blood thinners like warfarin, which cost as little as $10 to $30 per month, the difference is staggering.

However, Eliquis is not the most expensive anticoagulant. Pradaxa (dabigatran), another direct oral anticoagulant (DOAC), can cost over $550 for a 30-day supply, while Xarelto (rivaroxaban) is priced at around $600 per month. The high cost of these medications is largely due to patent protections, research and development expenses, and the lack of widely available generics in the U.S.

Patients looking for more affordable alternatives often consider international pharmacies, where the same medications can be significantly cheaper. For example, in Canada, a 168-tablet supply of brand-name Eliquis costs around $174, nearly 90% less than in the U.S. Generic versions (apixaban) are also available in Canada and other countries at a fraction of the price. While Eliquis is undoubtedly expensive, it remains one of the most effective and widely prescribed blood thinners due to its lower risk of bleeding complications compared to warfarin. The high cost, however, continues to be a major concern for patients seeking affordable long-term treatment.

Why is the price of Eliquis so high?

The high price of Eliquis is due to several factors:

Patent protection

Eliquis has been a subject of discussion due to its high cost in the United States. One of the primary reasons for its expensive price tag is patent protection, a crucial factor in the pharmaceutical industry. Patent protection grants pharmaceutical companies exclusive rights to produce and sell their newly developed drugs for a specific period, typically around 20 years. This exclusivity allows pharmaceutical companies to recoup their substantial investments in research and development.  In the case of Eliquis, Bristol Myers Squibb and Pfizer, the drug’s manufacturers, have managed to extend their patent protection through various legal means.

Although the U.S. Food and Drug Administration approved generic versions of Eliquis (apixaban) in 2020, the brand-name medication has maintained its patent exclusivity in the U.S. market. Thanks to successful legal challenges and settlements, Bristol Myers Squibb and Pfizer have fended off cheaper alternatives until at least 2026, with some sources indicating that generics may not enter the market until April 2028. This extended period of exclusivity has significant implications for consumers. Without generic competition, Eliquis can command a premium price in the U.S. market, often costing over $500 for a month’s supply. The lack of alternatives leaves patients and healthcare systems with limited options, contributing to the ongoing debate about prescription drug pricing in America.

Research and development costs

Developing innovative drugs involves significant investment. Research and development (R&D) costs play a significant role in the high price of Eliquis. Pharmaceutical companies often cite these expenses as a key factor in setting drug prices. The process of developing a new drug is lengthy and costly. On average, it takes 12-13 years and approximately $1.4 billion to bring a new medication to market. This substantial investment covers various stages of drug development, including early discovery, preclinical testing, and multiple phases of clinical trials. 

For Eliquis specifically, while exact figures aren’t publicly available, it’s reasonable to assume that its development followed a similar pattern of high investment. However, it’s important to note that the relationship between R&D costs and drug pricing is complex. 

While pharmaceutical companies argue that high prices are necessary to recoup their investments, critics point out that many top-selling drugs, including Eliquis, have generated revenues far exceeding their development costs. For instance, Medicare alone spent $27.2 billion on Eliquis between 2016 and 2020, which is more than ten times the average cost to develop a new drug.

Furthermore, research has shown that many pharmaceutical companies spend more on stock buybacks and dividends than on R&D. This suggests that while R&D costs are a factor in drug pricing, they are not the sole determinant.

As research continues and pricing practices evolve, the debate over the true impact of R&D costs on drug prices is likely to persist.

Lack of pricing regulations

The U.S. does not cap drug prices, allowing manufacturers to set high rates.

One of the key factors contributing to the high cost of Eliquis in the United States is the lack of pricing regulations for prescription drugs. Unlike many other developed countries, the U.S. government does not impose restrictions on how much pharmaceutical companies can charge for brand-name medications. This absence of price controls allows drug manufacturers to set prices based on what the market will bear, rather than on factors such as production costs or affordability for patients. As a result, the same medication can cost significantly more in the U.S. compared to other countries. 

The stark price difference is further exacerbated by the inability of government programs like Medicare to negotiate drug prices directly with pharmaceutical companies. This limitation, coupled with extended patent protections, enables manufacturers to maintain high prices for brand-name drugs like Eliquis without facing significant market pressures to reduce costs.

The impact of this lack of pricing regulation is profound, with many American customers struggling to afford their necessary medications. While some relief may be on the horizon, with Medicare beginning to negotiate prices for certain drugs, the current system continues to place a significant financial burden on patients and the healthcare system as a whole.

Customers without insurance – Impact?

Although generic versions of Eliquis were FDA-approved in 2020, legal disputes have delayed their availability. Current patents extend exclusivity until November 2026, meaning generics likely won’t be widely available until after this date.

The high cost of Eliquis has a significant impact on uninsured patients in the USA:

• Financial burden: Uninsured consumers typically pay a lot more for a 30-day supply of Eliquis, depending on dosage and quantity. This high price can make it extremely difficult for patients to afford their prescribed treatment.
• Full price payment: Uninsured consumers, with no one to negotiate on their behalf, are forced to pay full price for their medications—if they are able to afford them at all.
• Limited access: The high cost may lead some uninsured consumers to ration their medication or forgo treatment entirely, potentially compromising their health outcomes.

The Cheapest Way to Get Eliquis

How to Pay About $1 Per Pill?

Many Americans facing high prescription drug costs have found relief through international and Canadian online pharmacies, which offer significantly lower prices on essential medications. This practice has deep roots, dating back to the early 2000s when an Ohio state senator organized bus trips across the Canadian border to help seniors access affordable prescriptions.

This trend continues today. In 2019, CBC News documented a renewed surge in Americans seeking medications north of the border. The report revealed that some physicians now directly contact Canadian pharmacies to arrange prescriptions for their patients, while those living near the Canadian border simply make the drive themselves. The convenience factor makes this option even more attractive. Rather than traveling internationally, Americans can now order their prescriptions online from home and have them delivered directly to their doorstep, combining substantial cost savings with the ease of home delivery.

You can access a Canadian pharmacy through MedicationsCanada.com to buy a 56-tablet supply of Eliquis for $63.95. Navigating prescription drug costs is always stressful and overwhelming. Our goal is to help you save money. To save money on your prescription medications, call us toll-free at +1-866-481-5817.

Opt for 90-Day Supplies

Purchasing a 90-day supply of Eliquis can further reduce costs:

1. Lower per-pill cost: Buying in bulk often results in a lower price per tablet.
2. Fewer pharmacy trips: This means fewer copays if you have insurance.
3. Convenience: You’ll need to refill your prescription less frequently.

At MedicationsCanada.com, a 168-tablet supply (approximately 90 days) of Eliquis 5mg is priced at $173.95, offering even greater savings compared to smaller quantities.

By combining these two strategies, purchasing from a Canadian pharmacy and opting for a 90-day supply, you can significantly reduce your Eliquis expenses while ensuring a consistent supply of this crucial medication.

References

1. Eliquis Prescribing Information. 2012. https://www.accessdata.fda.gov/drugsatfda_docs/label/2016/202155s012lbl.pdf
2. Eliquis Prices, Coupons, Copay Cards & Patient Assistance. 2025. https://www.drugs.com/price-guide/eliquis
3. Pradaxa Prices, Coupons, Copay Cards & Patient Assistance. 2025. https://www.drugs.com/price-guide/pradaxa
4. Xarelto Prices, Coupons, Copay Cards & Patient Assistance. 2025. https://www.drugs.com/price-guide/xarelto
5. Top 10 drugs with patents due to expire in the next five years. 2024. https://www.proclinical.com/blogs/2024-2/top-10-drugs-with-patents-due-to-expire-in-the-next-5-years
6. Investor Statement on Eliquis Revenue Under IRA. 2024. https://www.bms.com/investor-statement-on-eliquis-revenue-under-ira.html
7. Pharmaceutical industry profile. 2024. https://ised-isde.canada.ca/site/canadian-life-science-industries/en/biopharmaceuticals-and-pharmaceuticals/pharmaceutical-industry-profile
8. Medicare Spending on Prescription Drugs Far Outpaces Development Costs. 2022. https://www.aarp.org/politics-society/advocacy/info-2022/medicare-prescription-drug-spending.html
9. Medicare now negotiating price of drug that costs $7,100 in US vs. $900 in Canada. 2024. https://www.cnn.com/2024/02/06/politics/medicare-drug-prices-eliquis-bernie-sanders/index.html 
10. 6 Savings Tips for Eliquis While Its Generics Are on Hold. 2020. https://www.goodrx.com/eliquis/eliquis-generics-approved-patent-expiration-ways-to-save
11. Paying the Price. 2006. https://pirg.org/wp-content/uploads/2012/01/PayingthePriceDC_0.pdf
12. Eliquis and Cost: What You Need to Know. 2023. https://www.healthline.com/health/drugs/eliquis-cost#next-steps