Bristol Myers Squibb and Pfizer have announced a new direct-to-patient purchasing option for Eliquis (apixaban), offering eligible U.S. patients a cash price more than 40% below the current list price of $606 for a 30-day supply. The program will launch September 8, 2025, through the companies' existing Eliquis 360 Support patient assistance program.
The initiative targets uninsured, underinsured, or self-pay patients who have an Eliquis prescription, providing direct shipping across all 50 states and Puerto Rico. According to Christopher Boerner, Ph.D., board chair and CEO of Bristol Myers Squibb, "This program passes more savings directly to patients and demonstrates our continued focus on identifying innovative solutions that foster the best outcomes for each individual while prioritizing access to care."
Blockbuster Drug Faces Pricing Pressures
Eliquis represents a significant revenue driver for Bristol Myers Squibb, with the blood thinner contributing to the company's 7% revenue increase in 2024. Worldwide, Eliquis generated $13.3 billion in 2024, with $9.6 billion coming from U.S. sales alone, according to the company's 2024 earnings release.
The drug's commercial success has also made it a target for government price negotiations. Eliquis was included on CMS's first list of drugs negotiated under the Inflation Reduction Act, with the agency securing a 56% discount off the monthly list price in 2023. This negotiated price will take effect in January 2026.
Medicare Part D spent $16.48 billion for the 3.7 million people who took Eliquis between June 1, 2022, and May 31, 2023, making it the drug with the highest spending in Medicare Part D, according to CMS officials.
Clinical Impact and Market Position
More than 15 million Americans have been prescribed Eliquis since its launch, with the companies reporting that the medicine has resulted in an estimated $3 billion in total healthcare cost savings and avoidance for every 100,000 patients treated. These savings include reduced hospitalization and extended rehabilitation needs.
Eliquis is indicated for multiple uses in adults, including reducing the risk of stroke and blood clots in patients with atrial fibrillation, treating blood clots in leg veins (deep vein thrombosis) or lungs (pulmonary embolism), and helping prevent blood clots following hip or knee replacement surgery. The drug is also approved for pediatric use in treating venous thromboembolism.
Growing Direct-to-Consumer Trend
The Bristol Myers Squibb-Pfizer initiative reflects a broader industry trend toward direct-to-consumer pharmaceutical sales. Eli Lilly offers Zepbound (tirzepatide) for obesity treatment and various insulins through LillyDirect. Novo Nordisk sells drugs including Wegovy (semaglutide) through NovoCare Pharmacy. Pfizer operates PfizerForAll, which provides discounts on medications including Paxlovid (nirmatrelvir and ritonavir) for COVID-19 treatment and Xeljanz (tofacitinib) for rheumatoid arthritis.
Industry Criticism and System Challenges
The direct-to-patient model has drawn criticism from healthcare policy experts. Antonio Ciaccia, CEO of 46brooklyn Research, characterized BMS's program as "another niche program that can provide good relief to those who need it but avoids the root cause of bloated drug list prices, which necessitate the existence of the program in the first place."
Ciaccia noted that "the fact that this is even a thing is the indicator that the architecture of our system is absurd, overly complex, and misaligned with the interests of patients—all so we can maintain our overarching addiction to bloated discounts off bloated prices."
Medicare Pricing Complexities
Despite the upcoming Medicare price negotiations, Bristol Myers Squibb officials have emphasized that the negotiated price doesn't necessarily determine patient out-of-pocket costs. According to the Eliquis website, patients with Medicare prescription insurance pay an average of $54 per month, with 5 out of 10 patients paying $40 or less.
The company notes that "The new Medicare pricing does not set what Medicare patients will pay for Eliquis now or in the future; that amount is determined by your prescription insurance plan," highlighting the complexity of pharmaceutical pricing and patient cost-sharing arrangements.
