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Medically reviewed by, Russell Braun RPH
Eliquis (apixaban) is a drug that offers a new way to treat blood clots. It works by influencing the way your body forms blood clots. Eliquis inhibits a natural protein in the blood (factor Xa) from working to make the clots.
Certain patients are more prone to blood clots. Those clots in the vascular system can lead to some dire consequences. Eliquis is used to prevent or treat the following conditions.
- Atrial fibrillation
- Deep vein thrombosis (DVT)
- Pulmonary embolism (PE)
The risk of these conditions can be short term for example after a surgery of the knee or hip. However, with atrial fibrillation and congestive heart failure the risk of DVT, PE or stroke are ongoing. Therefore, Eliquis can become a medication needed for an indefinite amount of time, also known as a maintenance medication.
The high cost of Eliquis can put a serious financial burden on patients who have to pay full price. Let’s look at what you can to to prevent that from happening to you.
1. How much does Eliquis cost?
Cash prices for eliquis are high! With no insurance a 30 day supply of either the 2.5mg or 5mg strength will cost $448 according to GoodRx.
Different pharmacies may have slightly different prices, but they will all be in that price range. At nearly $5400 per year the cost of just this one drug can be a major drag on a budget.
2. Is a generic available?
Currently, Eliquis is brand name only. Generic drug manufacturers will start to enter the market once the patent expires.
However, Bristol Myers Squibb has a lot to say about generic competitors. In 2018 the revenue for Eliquis alone was 6.3 billion dollars. With that much on the line Bristol Myers Squibb has sued 13 potential generic manufacturers for patent infringement. These court proceedings prevent any generics from coming to market until they are resolved.
Between a patent that expires in 2023 and the court proceedings, it could be years before a generic to Eliquis is available for sale.
3. How much does Eliquis cost with Medicare Part D?
Eliquis has been proven to be effective and has earned itself a spot on most Medicare Part D formularies. That means for Part D the cost would come down to what your deductible, copay or coinsurance would be.
If you have a high deductible health plan, copay coupons from the manufacturer can not be used for Medicare or Medicaid.
4. What drug can be used in place of Eliquis?
There are many drugs on the market that can thin your blood. However, not all of them work in the same way as Eliquis. The table below lists drugs that work in a similar manner to Eliquis to thin the blood.
|Brand Name||Generic Name|
Due to the risk of bleeding while taking Eliquis or alternatives, wearing an ID bracelet is a great idea. This lets emergency medical professionals quickly know your condition and save precious time during a potential emergency.
5. Is there a cheaper alternative to Eliquis?
Xarelto and Pradaxa are both brand only like Eliquis. Pradaxa is slightly cheaper but still over $400. Warfarin is much less expensive, however requires frequent monitoring to stabilize the drug in a therapeutic range. If you maintain a steady diet and do not mind the up front office visits to stabilize the drug, then warfarin will be much cheaper over time.
Eliquis won in head to head studies
In a study that compared Eliquis to Pradaxa, Xarelto and warfarin, they were all four found to be equally effective at preventing blood clots.
The problem with blood thinning drugs is they can also cause the blood to become too thin. This can be very dangerous because it can cause hemorrhagic stroke. This a type of stroke where you bleed into your brain instead of having a clot which is known an ischemic stroke.
The study revealed that Eliquis had the lowest risk of the hemorrhagic stroke, a potential side effect of all four drugs. This has made it a very popular option with doctors due to less need to monitor the patient frequently.
Should I request Eliquis over the alternatives?
You should discuss with your doctor. Certain patients will have a very low risk of hemorrhagic stroke with warfarin. If you have a low risk and can save a significant amount with warfarin then by all means try that route. When you think about the cost of warfarin you need to include the cost of copays if any are required for the frequent visits to have labwork done.
If Eliquis is the right drug for you how else can you lower the cost?
6. Patient assistance program (PAP’s)
Patient assistance programs as the name implies are setup to help patients be able to afford drugs like Eliquis. You should always apply for patient assistance programs before you opt for copay coupons, discussed later.
PAP’s are one great way to get prescription savings with or without insurance.
Eliquis was a joint venture drug between Pfizer and Bristol-Myers Squibb. They both play a part in the patient assistance program. Bristol-Myers Squibb maintains the site where you can apply for the assistance. However, Needymeds.org provides all the information in a nice summarized fashion.
Here are the important points to remember:
- To qualify you must not have insurance
- Income can be up to 300% of the federal poverty level, documentation will be required
- Patients must reside in the United States
- Doctor must sign paperwork
If you have insurance the first thing you need to investigate is which drug is on formulary. The more preferred formulary status a drug has the cheaper it will be for you in the form of your copay or deductible.
Eliquis may not be the formulary option for your insurer. In that case if your doctor determines it is the best drug for you a formulary exception can be requested. Since Eliquis has documented efficacy and is has been proven to have fewer side effects, most formulary exceptions will be granted. Your doctor will simply have to document why you need Eliquis.
For more ways to save money on medications with insurance click here.
When your doctor decides to put you on a new medication, it should always be expected that you are going to give it a trial. Medications can have side effects and not everyone will be able to tolerate Eliquis. For this reason, you should be closely noting how you feel while taking the medication. For more on this check out 5 reasons for bullet journaling medication use.
Medication that costs $448 for 30 days supply can’t be taken back to the pharmacy if you determine you can’t take it due to side effects. That is why you need to ask your doctor for samples of at least two weeks to evaluate if you can tolerate the medication.
In addition to samples you should request the Eliquis the free trial that Bristol-Myers Squibb offers. It provides a free 30 day supply if you present a valid 30 day prescription from your doctor. Essentially you are getting 60 day supply for the 30 day price.
9. Copay coupon cards
Copay coupons are provided by drug manufacturers to help offset the cost of copays for patients. They are accepted at most pharmacies and can lower the amount you have to pay out of pocket substantially.
With the Eliquis copay coupon card if eligible you pay no more than $10 for a 30 day supply. The coupon is good for 24 months and a maximum annual amount of $3800.
Wait, that doesn’t add up?
Remember I said that Eliquis costs $448 per 30 day supply? Well if you multiple that by 12 month you get $5376. That means if you are in a high deductible health plan and you have a deductible of $5000 or more, you will be on the hook for the difference.
Your deductible is $7500.
Eliquis is $5376 per year, minus $3800 provided by the copay coupon = $1576
Since you have a $7500 deductible you are on the hook for the full $1576!
This is why I encourage people to look at other options before trying the copay coupon card offer. If you have insurance that is not high deductible and your copays are not excessive then the coupon will probably save you money. You can request an Eliquis copay coupon here.
10. Mail order
Many insurance plans will offer you savings if you use their mail order pharmacy. The copay might be the same for a 90 day supply at mail as it is for a 30 day supply at retail. Another added benefit is the medication is delivered right to your doorstep.
Bristol-Myers Squibb offers a rebate program for those who want to take advantage of mail order pharmacies. The rebate allows you to realize copay savings at mail order similar to what the copay coupon card does at retail pharmacies.
11. Splitting tablets
Eliquis comes in two strengths, 2.5mg and 5mg. The drug is normally taken twice a day. If you are on the 2.5mg twice a day regimen you can save tremendous amount of money by splitting 5mg tablets in half.
The reason for this is that Eliquis 2.5mg tablets are the same cost as the 5mg. You can essentially cut your cost in half by splitting 5mg tablets and taking one half tablet twice a day.
Some things to keep in mind if you split tablets:
- Get a pill splitter from a pharmacy. They are inexpensive and make it easy for you to split the tablet accurately.
- Only split the tablet you are taking that day, not all the tablets at the same time. When you take your first dose in the morning split the tablet and take the other half for your second dose later in the day.
- Let you doctor and pharmacist know you are using this money saving tactic.
Click here to get Dr. Jason Reed’s exclusive list of medication questions you MUST ask your doctor, for FREE!
Have you tried Eliquis?
Please leave a comment and let everyone know if Eliquis worked for you. If you used any of these savings techniques please let me know what worked best.