Last updated: August 4, 2025
Introduction
The drug with NDC 00527-2170 is identified as Eliquis (apixaban), an anticoagulant developed by Bristol-Myers Squibb and Pfizer. Approved by the FDA in 2012, Eliquis has established itself as a leading agent for preventing stroke in non-valvular atrial fibrillation, treatment and prevention of deep vein thrombosis (DVT), and pulmonary embolism (PE). Its market dynamics resonate with the broader anticoagulant landscape, characterized by evolving clinical guidelines, patent expirations, and competitive pressures.
This report provides an in-depth market analysis, current pricing standards, and future price projections for Eliquis, considering key factors influencing market volume, pricing strategies, and potential patent-related impacts.
Market Overview
1. Market Penetration and Prescribing Trends
Eliquis boasts significant market share among direct oral anticoagulants (DOACs), competing predominantly with rivaroxaban (Xarelto), dabigatran (Pradaxa), and edoxaban (Savaysa). As of 2022, Eliquis commanded approximately 45% of the DOAC global market, driven by its favorable safety profile, specifically lower bleeding risks, and broad FDA indications.
The rising prevalence of atrial fibrillation (AFib)—estimated to affect over 6 million Americans—coupled with expanding indications in DVT and PE treatment, sustains high demand. Growth is further fueled by expansion into new markets, including prophylactic stroke prevention in cardioembolic AFib, and off-label use in orthopedic and cancer-associated thrombosis.
2. Competitive Landscape
Compared to rivaroxaban and dabigatran, Eliquis has distinguished itself through:
- Efficacy and safety: Multiple studies (e.g., ARISTOTLE trial) have demonstrated Eliquis’s superior safety profile.
- Prescriber preference: Extensive real-world evidence and physician familiarity bolster its prescribing patterns.
- Pharmacokinetic advantages: Favorable dosing and fewer food interactions are increasing acceptance.
However, declining patent exclusivity and the entrance of generic formulations threaten price stability and market share.
3. Patent and Regulatory Environment
While Eliquis's primary patent protections began expiring in 2026 (depending on jurisdiction), Bristol-Myers Squibb and Pfizer have pursued legal strategies to extend exclusivity via manufacturing patents and formulation patents. Generic entries are anticipated between 2026 and 2028, likely triggering significant price competition.[1]
Pricing Trends and Current Market Prices
1. List and Wholesale Prices
As of Q1 2023, the average wholesale acquisition cost (AWAC) per 30-day supply of Eliquis is approximately $500–$550 (United States). These figures vary by dosage and pharmacy negotiations.
2. Insurance and Reimbursement Impact
Reimbursement rates, insurance contracts, and pharmacy benefit manager (PBM) negotiations significantly influence out-of-pocket costs for patients. Median copayments for insured patients typically range from $10–$50 per month.
3. Access and Formulation Variations
Combination packages (e.g., 2.5 mg and 5 mg doses) and formulations (tablets) influence pricing, with higher-strength prescriptions often commanding slightly lower per-unit costs due to fixed co-pays.
Future Price Projections
1. Short-term Outlook (2023-2025)
- Stability in pricing: Current pricing levels are expected to remain relatively steady through 2024, supported by continued high demand and strong physician preference.
- Impact of biosimilar/parageneric competition: Although generic versions are not yet available, patent expirations imminent in 2026-2028 will exert downward pressure.
2. Mid to Long-term Outlook (2026 and beyond)
- Entry of generics or biosimilars: Anticipated initial discounts of 40%-60%, reducing average prices to approximately $200–$300 per month.
- Market adaptation: Price erosion will stimulate formulary shifts, with insurers favoring lower-cost alternatives, potentially impacting Eliquis’s market share.
3. Factors Influencing Price Trajectory
- Regulatory approvals of biosimilars in other markets could influence U.S. pricing strategies.
- Competitive strategies by Bristol-Myers Squibb and Pfizer include patent litigations, combination therapies, and labeling extensions to delay generics.
- Manufacturer discounts and rebates play a significant role in net price reductions.
Market Strategic Implications for Stakeholders
- Pharmaceutical companies should prepare for patent cliffs by diversifying R&D pipelines into next-generation anticoagulants.
- Insurers and PBMs will negotiate aggressive rebates and formulary placements to manage rising drug costs.
- Healthcare providers need to balance efficacy, safety, and cost in prescribing decisions, especially as generic options emerge.
- Patients stand to benefit from significant price reductions post-generic entry, improving access.
Key Takeaways
- Eliquis remains a leading anticoagulant with a robust market presence driven by clinically favorable efficacy and safety profiles.
- Current retail prices hover around $500–$550 for a 30-day supply, with variations based on dosage, insurance, and pharmacy.
- Patent expiration and emerging biosimilar options from 2026 onward will substantially lower prices, with expected reductions of 40%-60%.
- Strategic legal and market maneuvers by manufacturers could extend exclusivity, influencing short-term price stability.
- Stakeholders should prepare for a market transition towards more cost-effective generic alternatives in the coming years, impacting both profitability and access.
FAQs
Q1: When will generic versions of Eliquis become available in the United States?
A1: Patent protections are expected to expire around 2026-2028, opening the market to generic formulations, contingent upon legal outcomes and regulatory approvals.
Q2: How will the entry of generics affect Eliquis’s market share?
A2: Generics typically capture considerable market share post-launch, often surpassing 70-80%, which will significantly diminish Eliquis’s revenue and pricing power.
Q3: What price reductions are anticipated after patent expiry?
A3: Historically, generic entry reduces prices by approximately 40%-60%, indicating that monthly costs could fall to $200–$300.
Q4: How do insurance companies influence Eliquis’s pricing?
A4: Insurance providers and PBMs negotiate rebates and formulary placements, which can substantially lower patient out-of-pocket costs, though list prices remain stable.
Q5: Are biosimilars a consideration for Eliquis?
A5: Currently, biosimilars are less relevant for Eliquis, as it is a small-molecule drug. However, future formulations or combination therapies could influence the competitive landscape.
References
[1] U.S. Food and Drug Administration. Eliquis (apixaban) Label and Patent Information. 2022.
