Across the U.S., the fierce debate around the cost of prescription medications continues with no real prospect of a firm and lasting resolution. This is unsurprising when you consider that drug prices here are notoriously high and certainly far higher than other high-income countries, such as the United Kingdom and Canada.
However, what really does matter to these people is whether they can actually afford the prescription medicines they need and how much they can possibly save through using online discounts, coupons, assistance programs, and other ways to lower the cost of these vital drugs.
For people who struggle to pay the high prescription costs, the odd discount or coupon or other forms of assistance can make a real difference – it can even be the difference between buying groceries at the store or having to use the local food bank.
In the U.S., patients pay around 14% of their prescription medicine costs directly out of their own pockets. Sadly, in one particular survey, around 37% (1 in 3) of adults said they were unable to complete a prescribed course of medicine simply because of its cost.
What is Eliquis (Apixaban)?
Eliquis, also known as apixaban, is considered an expensive drug, costing around $471 USD for a one month course of 5 mg tablets in the U.S. (list price, as of January, 2021). In a class of medications called “factor Xa inhibitors,” which are anticoagulants, Eliquis works by stopping the blood from coagulating (clotting).
It is used to lower the risk of stroke in patients with atrial fibrillation, a type of arrhythmia that causes the heart to beat out of rhythm. It is also used to treat or prevent pulmonary embolisms (PE) or deep vein thromboses (DVTs). PE are clots that become lodged in the lungs, and DVTs are clots that form in deep veins, usually in the legs.
Unfortunately, there are currently no generic alternatives for Eliquis. Although most Medicare and insurance plans cover it, there are those patients who have to depend on pharmacy coupons and other forms of discount to be able to afford it.
How is Eliquis Used?
Eliquis comes in an oral tablet form, either 2.5 mg or 5 mg dose, and it’s usually taken with or without food twice a day. If you cannot swallow tablets, you can crush them alternatively and mix the resulting powder with water, apple juice, or even applesauce. Remember to swallow the mixture immediately after you prepare it.
You should take apixaban at around the same time every day – exactly as directed. Do not alter the dose prescribed by your doctor. You should complete the course of tablets, and you should continue to take Eliquis even if you feel well. If you stop taking the medication prior to the course ending or before consulting with your doctor, you may be at an increased risk of a blood clot.
What Do I Need to Know Before Taking Eliquis?
Important: Before taking Eliquis, you need to consult with your doctor about any special precautions, as the potential interactions with other medications and side effects can be serious.
- If you are taking Eliquis for atrial fibrillation, you are at a higher risk of stroke after you stop taking this medication. Consult your doctor first.
- If you have an epidural or spinal anesthesia or a spinal puncture while taking Eliquis, you are at risk of having a blood clot form in or around your spine, which could lead to paralysis. You may need to interrupt Eliquis when having surgery.
- As Eliquis prevents your blood from clotting normally, it can take longer than usual for you to stop bleeding if you are cut or injured, and you can bruise more easily. Contact your doctor immediately if the bleeding or bruising is unusual, severe, or cannot be controlled.
Drug Interactions (Mixing Eliquis with Other Medications)
Many prescription medicines will interact with others. You must tell your doctor and pharmacist if you are taking any of the medications listed here: Eliquis: Interactions.
Important: Some side effects resulting from taking Eliquis can be serious. If you experience any of the symptoms listed below, please call your doctor immediately or seek emergency medical treatment:
Eliquis: When Will Generic Versions Become Available?
On August 6, 2020, the joint manufacturers of Eliquis – Bristol Myers Squibb (BMS) and Pfizer – celebrated a victory in federal court which upheld their patent claims for the medication. The decision meant that any and all generic-producing rivals are blocked from producing generics for at least 6 years.
The Food & Drug Administration (FDA) has granted approval of the generic Eliquis (apixaban) applications to both Micro Labs Limited and Mylan Pharmaceuticals Inc. However, those companies reached a settlement with BMS and Pfizer that prevents either from entering the market until at least 2026.
How Much Will Eliquis Cost You Before the Generic Version Arrives?
Because of the federal court decision described above, a generic version of Eliquis will not become available for another 5 years (minimum). So, how much will you be spending on the medication until then?
Note: For simple calculation purposes, this is based on the list price of Eliquis remaining the same. Obviously, that will not happen, and the price will be increasing annually over the 5-year period. In fact, since 2014, the price of Eliquis has risen around 10% every year.
Here’s the math that matters:
30-day supply cost = $471* (list price, as of January, 2021) x 60 months (another 5 years) = $28,260 USD.
Nearly $30,000… Therefore, any discount off that price is going to be a sizable amount – possibly hundreds, even thousands of dollars.
Unsurprisingly, many, many people who take Eliquis are now asking themselves:
How Can I Get a Discount on My Eliquis Prescription?
Without a doubt, Eliquis is one of the more expensive prescription medicines. When a generic version finally reaches the U.S. public, its price will be markedly cheaper – between 80-85% cheaper. That amounts to a considerable saving compared with what people who need the drug are having to pay now, and will continue to pay for at least another 5 years.
So the big question is: “How Can I Get a Discount on My Eliquis Prescription?”
Here are the options currently available to you to lower the cost of your Eliquis prescription:
1. Use Your Health Insurance
As most Medicare and commercial health insurance plans include Eliquis on their list of covered medicines, and, of course, if you have health insurance in the first place, this is your best option – to claim the prescription cost through your insurance coverage.
However, you may still need to qualify by meeting certain requirements; for example, by either a prior Authorization Form or by completing Step Therapy:
- Prior Authorization: An approval of coverage from your insurance company (not your doctor). It is a restriction placed on certain medications by insurance companies, so they can subsequently decide if they will pay for it or not.
The authorization is only required on those prescriptions when billed through insurance. If you’re uninsured or pay in cash, you don’t need this authorization. You will need to confirm if your health insurance provider requires an authorization for Eliquis.
- Step Therapy: Considered by many to be just another form of prior authorization, step therapy is a restriction placed on certain medications by the health insurance provider, where you will need to show that less expensive medicines are ineffective before you can get coverage for a more expensive medicine.
In reality, step therapy means that you will have to try multiple drugs before you can get coverage for a specific, more expensive medication. Health insurance providers group medicines in 2 different categories for step therapy:
- First Choice Drugs: Also known as front-line or first step drugs, these are the generic and lower cost, brand-name drugs you will need to try before your insurer will cover a more expensive drug.
- Second Choice Drugs: Also known as back-up or second step drugs, these are the less preferred, more costly medicines.
- Here’s the step therapy process:
- If you submit a prescription at the pharmacy for a medication that requires step therapy, your pharmacist will contact your physician.
- Your physician will then write you a 30-day prescription for a less expensive first-choice drug.
- If, after you have completed the 30-day course, the first-choice drug is not treating your condition effectively, your doctor can fill out an “override” (an exception form), and send it to your insurer to request the more expensive second-choice drug.
- Normally, this process is successful. However, your insurer can always deny the request, leaving you to pay the full price of the second-choice medication.
2. Manufacturer’s Copay & Free Trial Cards
One of the manufacturers of Eliquis – Bristol-Myers Squibb – offers a copay card that can help to reduce your out-of-pocket payment for the medication. You must have commercial insurance and not Medicare or Medicaid to be able to qualify for a card. If you qualify for a copay card, you can lower your copay to around $10 per month, up to a maximum benefit of $3,800 per year.
Furthermore, Bristol-Myers Squibb also offers a free trial card that enables you to get your initial 30-day prescription at no cost whatsoever. You can use this offer regardless of having commercial insurance or not. To use either of these cards, simply show one to your pharmacist when collecting your prescription.
3. Buy in Bulk (Get a 90-Day Supply)
You may be able to save money on your Eliquis prescription if you fill a 90-day supply, instead of a shorter period, as larger prescriptions are sometimes cheaper long-term. Additionally, it cuts down trips to the pharmacy, and the number of co-pays you need to pay to your health insurer.
4. Fill Your Prescription at a Preferred Pharmacy
Many insurance plans belong to a preferred pharmacy network, a list of pharmacies they use to offer lower copays on your prescriptions. Some preferred pharmacy networks include mail order pharmacies, which can deliver certain medications to your door. Check to see if your insurance plan has lower co-pays for your medication at preferred retail or mail order pharmacies.
5. Consider Alternative Medications
You can always consider speaking to your provider to see if another, cheaper medication will be as effective as Eliquis for you. Similar anticoagulant medications to Eliquis include:
- Warfarin (Coumadin, Jantoven): Warfarin is a generic drug that is comparable with Eliquis but costs significantly less – as little as $4. However, it requires you to undergo regular blood testing and limit your dietary options. It also interacts with more medications than Eliquis.
- Pradaxa, Xarelto, and Savaysa: Similar medications to Eliquis, these drugs do not have cheaper, generic versions currently. However, they might be more affordable for you.
6. Patient Assistance Programs & The Rx Advocates
Patient Assistance Programs (or PAPs, for short) are normally sponsored by the pharmaceutical companies. However, there are also state programs and nonprofit-sponsored programs available. These programs enable those on a limited income who do not have health insurance coverage (or who have underinsured coverage) to receive their prescription medications at little or no cost.
Each program is different, so the benefits you receive can vary widely, and they often have different requirements. There is no standard enrollment process, as each program can define and set their own qualification standards. Generally-speaking, you will need to meet the following requirements (or similar):
- Be a permanent, legal resident of the United States or Puerto Rico
- Be able to prove you are uninsured or that your insurance doesn’t cover your medication
- Be able to meet certain income eligibility requirements, as defined by the chosen program
To sign up to a PAP, you can either call the program administrators or sign up online. You will need to submit forms such as taxes and residence status to prove you are eligible. Additionally, most PAPs require your health provider to complete a form. Once you have applied and enrolled, there may be limits on:
- How much medication you can get or
- How long the program will last
What is a Patient Advocate?
A patient advocate is an individual or organization that specializes in health care advocacy for patients, survivors, and caregivers. The patient advocate may be involved in a range of activities, such as patient rights and representation, and the support and education of patients, survivors and their carers.
The Rx Advocates: Who are We?
The Rx Advocates offer assistance with obtaining your prescription medication through patient assistance programs (PAPs). As a nationally recognized prescription advocacy program, we work with over 100 U.S.-based pharmaceutical manufacturers’ PAPs. Our medication list includes the top 100 prescribed medicines in the U.S., and we can assist with more than 800 FDA-approved medications.
There are no hidden costs or additional fees. Patients pay a set service fee ($60-$90 per month, depending on the number of medications they need assistance with). This fee includes 100% of the cost of the medication, regardless of its retail price.
- Agency for Healthcare Research & Quality: Medical Expenditure Panel Survey. Available at MEPS.AHRQ.gov.
- The Commonwealth Fund: “Access, Affordability, and Insurance Complexity Are Often Worse in the United States Compared to 10 Other Countries” (journal article). November, 2013. Available at CommonwealthFund.org.
- U.S. National Library of Medicine – PubMed Central: “Factor Xa inhibitors: a novel therapeutic class for the treatment of nonvalvular atrial fibrillation” (journal article). September, 2015. Available at NCBI.NLM.NIH.gov.
- American Heart Association: Atrial Fibrillation (information webpage). July, 2016. Available at Heart.org.
- Healthline: Pulmonary Embolism (information webpage). November, 2019. Available at Healthline.com.
- Healthline: Deep Vein Thrombosis (information webpage). November, 2019. Available at Healthline.com.
- Healthline: Apixaban (Eliquis) Oral Tablet – Interactions (information webpage). April, 2021. Available at Healthline.com.
- Bristol-Myers Squibb: Copay Card. Available at Eliquis.BMSCustomerConnect.com.
Bristol-Myers Squibb: Free Trial Card. Available at Eliquis.BMSCustomerConnect.com.