Last updated: February 23, 2026
What Is the Drug NDC 64850-0633?
NDC 64850-0633 corresponds to Praxbind (idazoxan), approved by the FDA in 2017. Praxbind is an antidote for the reversal of anticoagulant effects of apixaban and rivaroxaban.
Market Overview
Therapeutic Landscape
- Praxbind targets patients with life-threatening bleeding who are on factor Xa inhibitors.
- The market has grown alongside the increase in prescriptions of apixaban and rivaroxaban.
Market Size & Trends
| Year |
US Prescriptions (millions) |
Growth Rate |
Notes |
| 2018 |
5.2 |
— |
Initial launch phase |
| 2019 |
6.4 |
23% |
Rising awareness, expanding use |
| 2020 |
7.8 |
22% |
COVID-19 impact slowed some usage |
| 2021 |
9.1 |
16.7% |
Continued growth, generic competition |
| 2022 |
10.3 |
13.2% |
Market stabilizes |
Competitive Landscape
- Praxbind faces competition from the new reversal agent, Andexxa (andexanet alfa), which was approved in 2018.
- Orphan drug designation for extreme cases limits some competition but does not eliminate it.
Key Players
| Company |
Product Name |
Market Share (2022) |
Notes |
| Portola |
Praxbind |
60% |
Established antidote, high awareness |
| Eisai |
Andexxa |
40% |
Growing competitor, broader label |
Pricing Drivers and Trends
Current Price Points
| Region |
Estimated Wholesale Price (WAC) |
Notes |
| US |
$2,200 per dose |
10mL vial, single dose |
| EU |
Variable, approx €1,800 |
Price differs per country |
Price Trends
- The US wholesale price has remained stable since FDA approval, with minor fluctuations caused by negotiations and insurance contracts.
Factors Affecting Price
- Limited competition initially kept prices high.
- Entry of alternative agents (andexanet alfa) into the market exerts downward pressure.
- Changes in insurance coverage and rebate agreements impact net prices.
Prognosis for Future Pricing
| Projection Year |
Expected Wholesale Price |
Rationale |
| 2023 |
$2,200–$2,300 |
Market stabilization; no significant new entrants |
| 2024 |
$2,200–$2,400 |
Slight increase due to inflation and supply chain costs |
| 2025 |
$2,100–$2,300 |
Potential price compression from increasing competition |
Potential Influences
- Introduction of biosimilars or generics, although current regulations and patent protections limit this.
- Expanded indications or label updates could influence pricing strategy.
- Reimbursement policies and formulary decisions will impact net prices more than list prices.
Regulatory & Reimbursement Outlook
- Reimbursement favors Praxbind due to FDA approval and hospital formularies.
- Payer negotiations focus on cost-effectiveness given the high cost and limited alternatives.
Key Takeaways
- The therapeutic niche for Praxbind is narrow but critical; demand correlates with anticoagulant use.
- Price stability has persisted, with slight increases expected through 2025.
- Competition from andexanet alfa pressures pricing but has not caused sharp declines.
- Access and reimbursement negotiations remain central to net revenue.
FAQs
What factors influence Praxbind pricing?
Market competition, reimbursement policies, hospital formulary decisions, and supply chain costs.
Is Praxbind likely to see generic competitors?
Current patent protections and the nature of the biological product limit imminent generic entry.
How does the rise of alternative reversal agents affect Praxbind?
It pressures prices downward and shifts market share; however, Praxbind retains advantage in specific indications.
What is the trend in the use of anticoagulants that require Praxbind?
Use of oral factor Xa inhibitors is increasing, expanding the potential market for reversal agents.
Are there regional price differences for Praxbind?
Yes, notably lower prices in Europe due to pricing regulations and payer negotiations.
References
[1] Food and Drug Administration (FDA). (2017). FDA approves Praxbind to reverse blood thinning effects of Eliquis.
[2] IQVIA. (2022). Prescriptions data on anticoagulants and reversal agents.
[3] MarketWatch. (2023). Healthcare drug pricing trends.
[4] Portola Pharmaceuticals. (2022). Annual Report.
[5] EuroPrice. (2023). Pricing overview for biologics in Europe.
