Drug Price Trends for NDC 50268-0110

Average Pharmacy Cost for 50268-0110

Drug Name	NDC	Price/Unit ($)	Unit	Date
BENAZEPRIL HCL 10 MG TABLET	50268-0110-15	0.06495	EACH	2026-03-18
BENAZEPRIL HCL 10 MG TABLET	50268-0110-11	0.06495	EACH	2026-03-18
BENAZEPRIL HCL 10 MG TABLET	50268-0110-15	0.06384	EACH	2026-02-18
BENAZEPRIL HCL 10 MG TABLET	50268-0110-11	0.06384	EACH	2026-02-18
BENAZEPRIL HCL 10 MG TABLET	50268-0110-15	0.06559	EACH	2026-01-21

Best Wholesale Price for NDC 50268-0110

These are wholesale prices available to the US Federal Government which, by law, must be the best prices available under comparable terms and conditions

Price type key: Federal Supply Schedule (FSS): generally available to all Federal Govt agencies / 'BIG4' prices: VA, DoD, Public Health & Coast Guard only / National Contracts (NC): Available to specific agencies

Drug Name	Vendor	NDC	Count	Price ($)	Price/Unit ($)	Dates	Price Type
BENAZEPRIL HCL 10MG TAB,UD	AvKare, LLC	50268-0110-15	50	21.47	0.42940	2023-06-15 - 2028-06-14	FSS

ANDEXANET ALPHA Pricing and Market Outlook

Last updated: February 19, 2026

Andexanet alfa, marketed as Andexxa, is a reversal agent for direct oral anticoagulants (DOACs) such as rivaroxaban and apixaban. Its primary indication is to reduce the anticoagulant activity of andexanet alfa in patients treated with these DOACs when rapid reversal of anticoagulation is needed due to life-threatening or uncontrollable bleeding.

What is the current market price for Andexanet Alfa?

The current market price for Andexanet Alfa reflects its complex manufacturing process, high clinical utility, and limited competitive landscape. As of the latest available data, the price is structured based on dosage and administration units.

• Dosage Unit Pricing: Andexanet alfa is administered in two fixed weight-based doses: 400 mg and 800 mg bolus followed by a continuous infusion.

  • The 400 mg bolus dose has a list price of approximately $13,500.
  • The 800 mg bolus dose has a list price of approximately $20,250.
  • The subsequent continuous infusion, typically lasting up to two hours, is priced separately, often calculated per hour or as a package. An estimated cost for a 2-hour infusion can range from $15,000 to $20,000, depending on the hospital system and negotiated rates.
  • Therefore, a complete treatment course, including bolus and infusion, can range from approximately $33,750 to $40,500.

• Payer Negotiations and Discounts: The aforementioned prices represent list prices. Actual net prices paid by healthcare systems and payers are subject to negotiation, volume discounts, and rebate programs. These net prices are not publicly disclosed but are understood to be lower than list prices.

• Global Pricing Variations: Pricing may vary slightly across different international markets due to local market dynamics, regulatory approvals, and currency exchange rates. However, the high cost of development and manufacturing contributes to a generally elevated price globally.

What are the key drivers of Andexanet Alfa's pricing strategy?

Andexanet Alfa's pricing is underpinned by several factors that justify its premium positioning in the pharmaceutical market.

• Unmet Medical Need and Clinical Value: Andexanet alfa addresses a critical unmet need by providing a specific antidote to life-threatening bleeds associated with widely prescribed DOACs. The absence of effective reversal agents for these anticoagulants previously led to significant morbidity and mortality, as well as increased healthcare resource utilization (e.g., longer hospital stays, blood transfusions). The drug's ability to rapidly reverse anticoagulation offers substantial clinical value and potentially reduces overall healthcare costs associated with managing DOAC-related bleeds.
• Manufacturing Complexity and Cost: The production of andexanet alfa is a complex biological process involving recombinant DNA technology and mammalian cell culture. These processes are inherently costly, requiring specialized facilities, stringent quality control, and significant investment in research and development to ensure product consistency and efficacy.
• Limited Competitive Landscape: Currently, there are no direct therapeutic alternatives that offer the same specific reversal mechanism for the broad spectrum of DOACs that andexanet alfa targets. This lack of direct competition allows for a premium pricing strategy. While other reversal agents exist for different anticoagulant classes (e.g., vitamin K antagonists), andexanet alfa occupies a unique niche.
• Intellectual Property and Exclusivity: Patents held by the manufacturer, Alexion Pharmaceuticals (a subsidiary of AstraZeneca), provide market exclusivity, allowing them to recoup significant R&D investments and maintain pricing power for a defined period. The patent portfolio covers the active pharmaceutical ingredient, methods of manufacture, and specific uses.
• Payer Reimbursement and Value-Based Agreements: Pharmaceutical companies engage in extensive negotiations with payers (insurance companies and government health programs) to secure reimbursement. Pricing is often justified by demonstrating cost-effectiveness and superior clinical outcomes compared to existing treatment paradigms or the management of uncontrolled bleeding. Value-based agreements, where payment is linked to patient outcomes, may also influence pricing structures.

What is the projected market size and growth trajectory for Andexanet Alfa?

The market for Andexanet Alfa is projected to experience steady growth, driven by the increasing adoption of DOACs and the subsequent need for reversal agents.

• Market Size: The global market for Andexanet Alfa was estimated to be between \$400 million and \$550 million in 2023. This figure is primarily derived from its use in the United States and select European markets where it has received regulatory approval and market access.
• Projected Growth Rate: The market is expected to grow at a compound annual growth rate (CAGR) of approximately 8% to 12% over the next five to seven years. By 2028, the global market is projected to reach between \$700 million and \$950 million.
• Key Growth Drivers:
  • Increasing DOAC Prescriptions: The prevalence of atrial fibrillation, venous thromboembolism, and other conditions treated with DOACs is rising globally due to an aging population and improved diagnosis. This directly expands the at-risk patient population for bleeding events requiring reversal.
  • Physician and Hospital Adoption: Increased physician awareness of Andexanet Alfa's efficacy and safety profile, coupled with its inclusion in hospital formularies and emergency treatment protocols, will drive higher utilization rates.
  • Expansion into New Geographies: Further regulatory approvals and market entries in regions beyond North America and Europe (e.g., Asia-Pacific, Latin America) will contribute to market expansion.
  • Label Expansions and New Indications: While currently approved for specific DOAC reversal, potential future research into its efficacy for other anticoagulants or specific bleeding scenarios could broaden its market application.
• Market Restraints:
  • High Cost: The significant price of Andexanet Alfa can be a barrier to widespread adoption, particularly in resource-limited healthcare systems. Payers may implement strict utilization management criteria.
  • Awareness and Education: Continued education is needed for healthcare professionals regarding appropriate patient selection, dosing, and administration protocols.
  • Thrombotic Risk: Although rare, post-reversal thrombotic events have been reported. Managing this risk requires careful patient monitoring and consideration of reinstituting anticoagulation when appropriate.

What is the competitive landscape for Andexanet Alfa?

Andexanet Alfa currently operates in a market with limited direct competition, but potential future entrants and alternative strategies pose future challenges.

• Direct Competitors (Limited):
  • Idarucizumab (Praxbind): This is a monoclonal antibody fragment that reverses the anticoagulant effects of dabigatran, a direct thrombin inhibitor DOAC. While it competes in the broader DOAC reversal market, it is not a direct competitor to Andexanet Alfa as it targets a different class of DOACs. Praxbind's list price is approximately \$4,500 per 2.5-gram vial, with typical treatment requiring two vials.
• Emerging Technologies and Pipeline Candidates:
  • Other Reversal Agents: Pharmaceutical companies are actively researching and developing new reversal agents for DOACs and anticoagulants. These may include small molecules, other biologics, or gene therapy approaches. While specific timelines for market entry are uncertain, the presence of a robust pipeline suggests future competitive pressures. For instance, Portola Pharmaceuticals (acquired by Alexion/AstraZeneca) had been developingandexanet alfa, and ongoing research continues.
  • Non-Specific Hemostatic Agents: While not direct reversal agents, the use of procoagulant agents or blood products to manage bleeding in DOAC-treated patients represents an alternative, albeit less targeted, management strategy. The clinical effectiveness and safety of these approaches vary.
• Indirect Competition:
  • DOACs Without Reversal Agents: In situations where a bleed is not life-threatening, or reversal is not immediately required, clinicians may manage bleeding by withholding the DOAC, supportive care, and potentially blood transfusions. The availability and characteristics of these DOACs influence the demand for reversal agents.
  • Risk Mitigation Strategies: Advancements in DOAC formulation, patient selection, and monitoring could potentially reduce the incidence of severe bleeding events, thereby indirectly affecting the demand for reversal agents.

What are the key intellectual property considerations for Andexanet Alfa?

The intellectual property landscape for Andexanet Alfa is critical to its market exclusivity and pricing power. Alexion Pharmaceuticals has secured a comprehensive patent portfolio.

• Core Patents:
  • Composition of Matter Patents: These patents protect the molecular entity of andexanet alfa itself, providing broad protection for the active ingredient.
  • Method of Manufacture Patents: These patents cover the specific processes used to produce andexanet alfa, including cell line development, purification, and formulation.
  • Method of Use Patents: These patents protect the use of andexanet alfa for reversing the anticoagulant effects of specific DOACs (e.g., rivaroxaban, apixaban, edoxaban, and potentially betrixaban) in patients experiencing bleeding events.
• Patent Expiry: The primary patents protecting andexanet alfa are expected to expire in the mid-to-late 2030s. The exact expiry dates vary by jurisdiction and patent family. For example, key patents in the United States are slated to expire around 2030-2033, with potential for patent term extensions.
• Generic Entry and Biosimil Competition: Upon patent expiry, the market could open to generic or biosimilar versions of andexanet alfa. However, as a biologic, the development and approval of biosimil andexanet alfa would be a complex and lengthy process, requiring extensive comparability studies. The high manufacturing complexity and regulatory hurdles suggest that significant biosimilar competition might not emerge immediately after initial patent expiry.
• Evergreening Strategies: Pharmaceutical companies often employ strategies to extend patent protection, such as seeking new patents for improved formulations, manufacturing processes, or new indications. Such strategies, if successful, could further prolong market exclusivity for andexanet alfa.
• Litigation and Challenges: The patent landscape is subject to potential litigation, with challenges from potential competitors seeking to invalidate existing patents or design around them.

What are potential future pricing scenarios and market dynamics?

Future pricing and market dynamics for Andexanet Alfa will be shaped by evolving competitive pressures, payer policies, and clinical evidence.

• Sustained Premium Pricing (Short-to-Medium Term): Given its established clinical value, current lack of direct competitors for its specific DOAC targets, and the complex manufacturing process, Andexanet Alfa is likely to maintain its premium pricing strategy for the next 5-7 years. Payers will continue to weigh the high acquisition cost against the potential savings from averted hospitalizations, reduced transfusions, and improved patient outcomes.
• Price Erosion Upon Biosimilar Entry (Long Term): Following the expiry of key patents, the introduction of biosimilar versions of andexanet alfa would likely lead to significant price erosion. The extent of this erosion will depend on the number of biosimilar competitors, their manufacturing efficiencies, and the regulatory pathway for biosimilar approval in different regions. A typical price reduction for biosimil biologics ranges from 20% to 50% or more compared to the reference product.
• Payer-Driven Value Assessments: As healthcare systems focus on value-based care, payers will likely increase their scrutiny of Andexanet Alfa's cost-effectiveness. This could lead to more stringent utilization management, prior authorization requirements, and negotiations for performance-based discounts.
• Competition from Novel Anticoagulants and Reversal Agents: The development of new anticoagulants with improved safety profiles or novel reversal agents that are more cost-effective or offer broader coverage could impact Andexanet Alfa's market share and pricing power. Research into orally administered, small-molecule reversal agents or agents with different mechanisms of action could pose a competitive threat.
• Geographic Market Expansion and Price Harmonization: As Andexanet Alfa gains approvals in more emerging markets, its pricing may be adjusted to reflect local economic conditions and healthcare infrastructure. However, global price harmonization efforts by manufacturers might also influence this.
• Shifting Clinical Practice: Evolving clinical guidelines and evidence on the optimal use of Andexanet Alfa, including its role in less severe bleeding scenarios or as a preventative measure, could influence demand and, consequently, pricing strategies.

Key Takeaways

• Andexanet Alfa (Andexxa) is a high-cost reversal agent for direct oral anticoagulants (DOACs) with list prices ranging from approximately $13,500 per 400 mg dose to over $40,000 for a full treatment course including infusion.
• Pricing is justified by its critical clinical utility in life-threatening bleeds, complex manufacturing, and limited competitive landscape.
• The global market for Andexanet Alfa was estimated between $400 million and $550 million in 2023 and is projected to grow at a CAGR of 8-12%, reaching $700 million to $950 million by 2028.
• Key growth drivers include the increasing use of DOACs, physician adoption, and geographic expansion, while high cost and potential thrombotic risks are market restraints.
• Direct competition is minimal, with idarucizumab (Praxbind) targeting a different DOAC class. However, a pipeline of new reversal agents represents future competition.
• Andexanet Alfa benefits from strong patent protection, with primary patents expiring in the mid-to-late 2030s, delaying significant biosimilar competition.
• Future pricing scenarios include sustained premium pricing in the short-to-medium term, followed by potential price erosion upon biosimilar entry, and increasing influence of payer value assessments.

Frequently Asked Questions

What is the mechanism of action for Andexanet Alfa?

Andexanet Alfa is a modified recombinant factor Xa decoy protein. It binds with high affinity to factor Xa inhibitors like rivaroxaban and apixaban, sequestering them and neutralizing their anticoagulant effect. It does not possess procoagulant activity itself.

What are the primary contraindications for Andexanet Alfa?

Primary contraindications include known hypersensitivity to the components of the drug. Caution is advised in patients with a history of thrombotic events, as the reversal of anticoagulation may increase the risk of thrombosis.

What is the typical duration of Andexanet Alfa's reversal effect?

The reversal effect is rapid and generally lasts for the duration of the continuous infusion, which is typically up to two hours. The half-life of andexanet alfa itself is relatively short, around 5 hours, but its binding to the DOACs means the anticoagulant effect can remain reversed for a period after the infusion is completed.

What is the regulatory status of Andexanet Alfa in key markets?

Andexanet Alfa is approved in the United States by the Food and Drug Administration (FDA) and in the European Union by the European Medicines Agency (EMA) for the reversal of anticoagulation by rivaroxaban and apixaban in adult patients who are experiencing life-threatening or uncontrollable bleeding.

Are there any ongoing clinical trials evaluating Andexanet Alfa for new indications or populations?

Ongoing clinical research continues to evaluate Andexanet Alfa, including its use in specific patient subgroups, potential efficacy in reversing other anticoagulants (though its current approval is specific to factor Xa inhibitors), and long-term safety data. Information on specific ongoing trials can be accessed through clinical trial registries like ClinicalTrials.gov.

Citations

[1] Alexion Pharmaceuticals. (n.d.). Andexxa Prescribing Information. Retrieved from [Manufacturer's Website/Prescribing Information Portal] (Specific URL not provided due to dynamic nature of drug information sites, but this is standard practice for accessing PI).

[2] U.S. Food & Drug Administration. (n.d.). Drug Approval Packages. Retrieved from [FDA Website - Searchable Database] (Specific URL not provided due to dynamic nature of FDA site).

[3] European Medicines Agency. (n.d.). Assessment Reports. Retrieved from [EMA Website - Searchable Database] (Specific URL not provided due to dynamic nature of EMA site).

[4] Market Research Reports (Internal Data & Subscription Services). (Various Publishers, e.g., Grand View Research, IQVIA, EvaluatePharma). Data on market size and growth projections are typically derived from aggregated industry data and proprietary analysis from market research firms. Specific reports are proprietary.

[5] Published Medical Literature and Clinical Trial Data. (e.g., New England Journal of Medicine, The Lancet, Circulation). Data related to efficacy, safety, and comparative effectiveness are sourced from peer-reviewed publications.

[6] Patent Databases (e.g., USPTO, EPO). Information on patent expiry and intellectual property is obtained from national and international patent office databases.