Eliquis (apixaban) is a popular blood thinner medication used to reduce the risk of stroke and blood clots in people with atrial fibrillation. It works by blocking factor Xa, a protein involved in blood clotting. While Eliquis is highly effective, the price tag can be quite high, especially for those without prescription drug coverage. Fortunately, there are some cheaper alternatives to Eliquis available. This article will explore those options.
- Eliquis is an expensive brand-name anticoagulant medication used to treat and prevent blood clots
- The high cost of Eliquis can be prohibitive for patients, especially those without prescription coverage
- Some cheaper prescription alternatives include warfarin, Xarelto, and Pradaxa
- Utilizing coupons, shopping around pharmacies, and prior authorizations can reduce Eliquis costs
- Eliquis is expected to go generic in 2026, which should substantially lower prices
- Natural supplements like ginger and turmeric may provide blood-thinning effects, but lack evidence and should not replace medication
Overview of Eliquis
Eliquis belongs to a class of medications called direct oral anticoagulants (DOACs). It was approved by the FDA in 2012 for reducing stroke risk in patients with non-valvular atrial fibrillation. Since then, it has also been approved to treat and prevent deep vein thrombosis (DVT) and pulmonary embolism (PE).
The active ingredient in Eliquis is apixaban. It works as a factor Xa inhibitor, meaning it blocks the activity of factor Xa and prevents the formation of blood clots.
Eliquis is prescribed at a dose of 5 mg twice daily for most patients. A reduced dose of 2.5 mg twice daily may be used in certain populations, such as the elderly.
While Eliquis does not require routine blood monitoring like warfarin, it still carries a risk of bleeding. Patients should monitor for signs of bleeding such as easy bruising, nosebleeds, bleeding gums, and blood in the urine or stool.
From the 1940s through 2010, warfarin (Coumadin, Bristol-Myers Squibb) was the only oral anticoagulant on the market in the U.S. for the treatment and prevention of thromboembolic disease. In 2010, the FDA approved dabigatran (Pradaxa, Boehringer Ingelheim), an oral direct thrombin inhibitor, for the prevention of thromboembolic events in patients with atrial fibrillation.1 In 2011, rivaroxaban (Xarelto, Janssen), an oral factor Xa inhibitor, was the second novel oral anticoagulant to be approved in the U.S. for the prevention of deep vein thrombosis (DVT) after hip or knee replacement and for the prophylaxis of cerebrovascular accidents (CVAs) and systemic embolism in patients with nonvalvular atrial fibrillation.2 Apixaban (Eliquis, Bristol-Myers Squibb) is the third novel oral anticoagulant to be approved in the U.S. for the management of thromboembolic disease.
One of the downsides of Eliquis is the high cost. On average, Eliquis costs over $500 per month without insurance. This places a significant financial burden on those paying out-of-pocket.
Warfarin (Coumadin) is an oral anticoagulant that has been used for decades to prevent and treat blood clots. It reduces the liver’s production of vitamin-K-dependent clotting factors.
Unlike Eliquis, warfarin is available as a very low-cost generic. With Polarbearmeds.com coupons, you can save up to 90%.
However, warfarin requires frequent monitoring with blood tests to ensure proper dosing. Patients must also watch their intake of vitamin K-rich foods, which can interfere with warfarin’s effects.
Still, for those looking strictly at cost, warfarin is typically the most affordable option. Patients who don’t mind the extra monitoring may find it offers significant savings over Eliquis.
Xarelto (rivaroxaban) is another oral factor Xa inhibitor that works similarly to Eliquis. It is also approved to reduce stroke risk in patients with atrial fibrillation.
Xarelto is taken once daily, which some patients may prefer over Eliquis’s twice-daily dosing. However, it still comes at a high cost if not covered by insurance.
The good news is that generic versions of Xarelto have been tentatively approved by the FDA. When these generics become available, likely sometime in 2024, the cost of rivaroxaban should drop significantly.
Pradaxa (dabigatran) is an oral direct thrombin inhibitor. By blocking the activity of thrombin, it prevents the formation of blood clots.
Pradaxa is approved to reduce stroke risk in patients with atrial fibrillation. It’s taken twice daily in most patients.
While brand-name Pradaxa is costly, generic dabigatran recently became available.
For patients looking specifically for a cheaper alternative to Eliquis, generic Pradaxa presents an affordable option.
Apixaban (Generic Eliquis)
In December 2019, the FDA approved generic versions of apixaban, the active ingredient in Eliquis. Several companies will eventually market generic apixaban.
Unfortunately, due to patent protections, these generic versions won’t be available until at least 2026. But once available, the cost of generic apixaban should be significantly lower than brand-name Eliquis.
For patients who can wait, generic apixaban is set to become the most affordable alternative to Eliquis. Those interested in the generic may want to ask their doctor to write prescriptions for the generic so that the pharmacy can automatically substitute it once available.
Savaysa (edoxaban) is another oral factor Xa inhibitor similar to apixaban and rivaroxaban. It’s approved to reduce stroke risk in patients with atrial fibrillation and taken once daily.
Unfortunately, Savaysa currently remains brand-name only. It does not present a more affordable alternative to Eliquis at this time. Generics are not expected until 2028.
Heparin and LMWH
Heparin and low molecular weight heparin (LMWH) products like Lovenox are injectable anticoagulants. While not oral agents like Eliquis, heparin and LMWHs are extremely low cost and present affordable options for short-term anticoagulation.
For example, generic enoxaparin (Lovenox) costs as little as $40 per month with GoodRx coupons. Generic unfractionated heparin is even cheaper.
Heparin and LMWHs require injection rather than oral dosing. But for short-term use, such as during a hospital stay, they offer an extremely affordable alternative to costlier injectable and oral anticoagulants.
Buy Eliquis from Canada
One little-known way to obtain brand-name Eliquis at a lower cost is to purchase it from an online Canadian pharmacy. In Canada, drug prices are lower across the board.
CIPA-certified online pharmacies are safe and legitimate options for Americans to legally import lower-cost drugs from Canada with a prescription. The savings can be significant, with Eliquis costing around 35-40% less from Canadian pharmacies like Polarbearmeds.com compared to US prices.
Americans interested in ordering from Canada should check that the online pharmacy has CIPA certification before ordering. This ensures that the pharmacy meets safety and legal standards. Working with a doctor to obtain a valid prescription is also important.
Using Coupons and Patient Assistance
For those with insurance prescription coverage, Eliquis manufacturer coupons can reduce copays by up to $300 per month. Uninsured patients may be eligible for medication at no cost through the Eliquis patient assistance program.
Apps like GoodRx can help patients compare drug prices between different pharmacies. Specialty pharmacies, like those that cater to the uninsured, can sometimes offer better rates on brand medications.
While still expensive, using such cost-savings methods can provide significant savings on brand-name Eliquis for those who have no other low-cost options available.
Weighing the Eliquis Alternatives
For patients with atrial fibrillation or recurrent blood clots, the high cost burden of long-term Eliquis treatment can seem daunting. But there are affordable alternatives to discuss with a healthcare provider.
In many cases, generic warfarin provides an extremely low-cost option for long-term anticoagulation. Though it requires monitoring and dietary caution, many patients manage warfarin well in exchange for the savings.
Currently, Pradaxa offers the cheapest DOAC option until generic Xarelto and apixaban become available. Heparin and LMWH products provide short-term, ultra low-cost injectable alternatives.
Purchasing brand-name Eliquis from Canada is another safe way to obtain the medication at a 35-40% discount. Coupons and patient assistance can also reduce out-of-pocket costs for those with insurance.
In the end, patients have to weigh medical fit along with affordability when selecting the optimal anticoagulant. But for many requiring long-term treatment, major cost savings are possible with alternative agents like warfarin and future Eliquis generics.
Other Ways to Reduce Eliquis Costs
Aside from exploring alternative prescription medications, there are some other strategies that may help reduce out-of-pocket costs for Eliquis.
Use Manufacturer Copay Cards
Bristol-Myers Squibb offers copay cards that allow patients with commercial prescription insurance to pay as little as $10 per month supply of Eliquis. Terms and restrictions apply.
Consider Mail Order Pharmacy
Getting a 90-day mail order supply of Eliquis may reduce the total number of copays over time compared to getting 30-day supplies at the pharmacy.
Compare Pharmacy Prices
Shop around and compare Eliquis prices between different pharmacies in your area, as costs can vary. Consider shopping at big-box stores or warehouse clubs which may offer lower costs.
Buy From an International Online Pharmacy
Purchasing brand-name Eliquis from an international online pharmacy can sometimes be cheaper than prices in the U.S. However, safety standards and regulations differ, so caution is advised.
Switch to a Lower Tier Drug with Insurance
If covered under a commercial insurance plan, consider switching to a drug on a lower tier, which likely comes with a lower copay. However, this should only be done under medical supervision.
Appeal for Prior Authorization or Exception
If Eliquis is not covered by your insurance, you may be able to get an exception or prior authorization with documentation from your doctor. This may allow the insurance company to cover Eliquis.
When Will Eliquis Go Generic?
The biggest question around costs for Eliquis is when a generic version will become available. As mentioned earlier, the patent exclusivity currently prevents any generic production of apixaban.
Generic drug manufacturers have challenged some of the patents. A tentative approval for generic apixaban has been granted by the FDA for manufacturers to produce their products ahead of patent expiration.
Based on current timelines, the first generics for Eliquis are expected to enter the market sometime around March 2026. Once launched, generic competition should drive prices down substantially. With generics, apixaban costs could decrease to around $100-150 for a monthly supply instead of over $450 for brand-name Eliquis.
Natural Blood Thinners
While not identical alternatives to Eliquis and other anticoagulant medications, some natural supplements are thought to provide blood-thinning effects. However, clear scientific data about efficacy and safety is lacking. Someone already taking Eliquis should never replace or stop it in favor of an herbal supplement without medical supervision.
Some natural products that may help thin the blood include:
- Ginger – Contains anti-platelet components similar to aspirin
- Turmeric – Active compound curcumin may prevent blood clotting
- Garlic – Has antiplatelet properties, may help thin blood
- Omega-3 fatty acids – Found in fish oil, may help prevent clots
- Nattokinase – Enzyme extracted from fermented soybeans
- Dong quai – Herb used in traditional Chinese medicine
These natural remedies lack conclusive evidence but are generally considered safe when consumed through dietary sources. However, the degree of anticoagulant effects can vary greatly. Again, natural blood thinners should never be used in place of doctor-prescribed anticoagulant medication.
Frequently Asked Questions
Why is Eliquis so expensive?
Eliquis is still under patent protection, meaning no generics are available yet. Brand-name drugs are typically far more expensive.
When will Eliquis become generic?
Generic Eliquis is expected to hit the market around March 2026 once patents expire.
What are some cheaper prescription alternatives to Eliquis?
Some potential alternatives include warfarin, Xarelto, and Pradaxa. While not identical to Eliquis, they provide cheaper options.
How else can I save money on my Eliquis prescription?
Strategies like prescription coupons, shopping around pharmacies, mail order programs, and prior authorizations may reduce out-of-pocket costs for Eliquis.
Can I take natural blood thinners instead of Eliquis?
Some supplements like ginger, turmeric, and garlic may have blood-thinning properties, but lack evidence. They should never replace doctor-prescribed medication like Eliquis without medical supervision.
The Bottom Line
Eliquis is an effective anticoagulant medication prescribed to millions of patients, but the high cost can present challenges. Luckily, there are some alternative options that work in a similar manner to reduce blood clotting.
Prescription medications like warfarin, Xarelto, and Pradaxa are among the potential alternatives. While not identical to Eliquis, they provide cheaper options for patients struggling to afford their medication.
A number of cost-saving strategies like prescription coupons, price shopping, and prior authorizations may also help patients lower their out-of-pocket costs for brand-name Eliquis.
Finally, the arrival of generic Eliquis in 2026 should substantially reduce prices and increase access. In the meantime, patients should discuss their alternatives with their healthcare provider to find the most affordable anticoagulant treatment option that provides the safety and efficacy they need.