Direct-to-Patient Apixaban Program Aims to Expand Access, Lower Out-of-Pocket Costs

Bristol Myers Squibb (BMS) and Pfizer have announced a new direct-to-patient program that allows eligible individuals to purchase blood thinner apixaban (Eliquis) at a significantly reduced price, in an effort to improve access and affordability for uninsured or underinsured patients.1

A 30-day supply of apixaban costs patients around $630 without insurance at most pharmacies. | Image credit: Semi – stock.adobe.com

The Eliquis 360 Support program, launched by the BMS-Pfizer Alliance, will allow patients with an apixaban prescription to order the anticoagulant directly from the manufacturer at more than a 40% discount off the list price, according to a BMS news release. Direct shipping will be available across all 50 states and Puerto Rico beginning September 8, 2025.

Program Targets Self-Pay Populations

The program is designed to help more than 15 million Americans who have been prescribed apixaban since its 2012 approval, particularly those without adequate prescription coverage.2 Apixaban is currently the most frequently prescribed oral anticoagulant in the US and is approved to reduce the risk of stroke and blood clots in adults with nonvalvular atrial fibrillation, treat deep vein thrombosis (DVT) and pulmonary embolism (PE), and prevent DVT/PE following hip or knee replacement surgery.1,3 It is also approved in children for venous thromboembolism following initial anticoagulant therapy.

The Eliquis 360 Support platform also provides educational tools and insurance navigation assistance. According to the news release, the program’s new pricing feature offers both transparency and convenience for patients looking to manage the cost of long-term anticoagulation therapy.

“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,” said Christopher Boerner, PhD, CEO and board chair of Bristol Myers Squibb.

The manufacturers also pointed to health system benefits, saying apixaban has generated about $3 billion in health care cost savings and avoidance—such as reduced hospitalization and rehabilitation needs—for every 100,000 patients treated.

Band-Aid Solution to a Bigger Issue?

The consensus in the managed care space is that lower costs are better for patients, but some experts argue this program serves more as a band-aid to a larger issue around prescription costs, insurance, and health care access in the US. Antonio Ciaccia, CEO of 46brooklyn Research and president of 3 Axis Advisors, called Eliquis 360 Support “another niche program that can provide good relief to those who need it,” but noted it does not address the root cause of inflated drug list prices.4

According to GoodRx, 60 tablets of apixaban 5 mg can cost patients around $630 without insurance at most pharmacies, ranging from $594 at ShopRite to $677 at Costco.5 Even after the 40% discount through the program, patients would still pay more than $350 for a 30-day supply. With commercially-insured patients paying about $38 or less a month and Medicare beneficiaries paying $54 or less, this means patients in the Eliquis 360 Support program would still be paying more than 9 times the cost for apixaban as their peers with commercial insurance and almost 7 times as much as with Medicare.6

“Regardless of its potential usefulness, 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,” Ciaccia wrote in a LinkedIn post.4 “We call this ‘having your cake and eating it too.’”

Brandon Antinopoulos, PharmD, vice president of the Pennsylvania Pharmacists Association and owner of Forward Rx, expressed concern that drug prices and access will become an even bigger issue in 2026. “In 3-5 years, insurance will only be accepted at CVS and grocery store pharmacies,” he wrote on LinkedIn responding to Ciaccia.7 “That and/or most independent pharmacies will be replaced by 340B health system pharmacies. I don't like that outlook, but that's where we're headed in my opinion. Primary care is community pharmacy's crystal ball."

References

1. Bristol Myers Squibb and Pfizer announce direct-to-patient Eliquis® (apixaban) option. News release. Bristol Myers Squibb. July 17, 2025. Accessed July 17, 2025. https://news.bms.com/news/details/2025/Bristol-Myers-Squibb-and-Pfizer-Announce-Direct-to-Patient-Eliquis-apixaban-Option/default.aspx
2. Eliquis (apixaban). Prescribing information. 2012. Accessed July 17, 2025. https://www.accessdata.fda.gov/drugsatfda_docs/label/2012/202155s000lbl.pdf
3. Simon TG, Schneeweiss S, Singer DE, Sreedhara SK, Lin KJ. Prescribing trends of oral anticoagulants in US patients with cirrhosis and nonvalvular atrial fibrillation. J Am Heart Assoc. 2023;12(3):e026863. doi:10.1161/JAHA.122.026863
4. @Antonio Ciaccia. We call this “having your cake and eating it too.” 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. Regardless of its potential usefulness, 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. https://lnkd.in/g-5cN7sW. July 17, 2025. Accessed July 17, 2025. https://www.linkedin.com/posts/antonio-ciaccia-390879b_exclusive-bristol-myers-and-pfizer-to-offer-activity-7351607511134752768-CaVr
5. Eliquis. GoodRx. Accessed July 17, 2025. https://www.goodrx.com/eliquis?label_override=eliquis&dosage=5mg&form=tablet&quantity=60
6. How much does Eliquis cost? Bristol Myers Squibb. Accessed July 17, 2025. https://www.eliquis.bmscustomerconnect.com/price
7. @Brandon Antinopoulos, PharmD. This is going to continue to grow even more so when 2026 rolls around and most pharmacies won't stock these medications. In 3-5 years, insurance will only be accepted at CVS and grocery store pharmacies. That and/or most independent pharmacies will be replaced by 340B health system pharmacies. I don't like that outlook, but that's where we're headed in my opinion. Primary care is community pharmacy's crystal ball. July 17, 2025. Accessed July 17, 2025. https://www.linkedin.com/feed/update/urn:li:activity:7351607511134752768?commentUrn=urn%3Ali%3Acomment%3A%28activity%3A7351607511134752768%2C7351614705469161474%29&dashCommentUrn=urn%3Ali%3Afsd_comment%3A%287351614705469161474%2Curn%3Ali%3Aactivity%3A7351607511134752768%29