Last updated: October 9, 2026
Eliquis, the apixaban anticoagulant marketed by Bristol Myers Squibb and Pfizer, generated approximately $13.3 billion in Bristol Myers Squibb worldwide sales in 2024, making it one of the company’s largest products. Demand remains strong because of its position in atrial fibrillation and venous thromboembolism treatment, but the product faces concentrated U.S. patent risk, Medicare price negotiation, and expected generic entry beginning in 2028 under settlement agreements.
The commercial outlook has two phases: continued growth through 2025, followed by a sharp U.S. revenue decline after generic launch. The core composition patent expires in 2026, while a later formulation patent has been listed through 2031. Generic manufacturers have settled Paragraph IV litigation with launch rights generally beginning April 1, 2028.
What is Eliquis and how large is its market?
Eliquis is the brand name for apixaban, an oral direct factor Xa inhibitor. Bristol Myers Squibb and Pfizer developed and commercialized the product through their alliance. The FDA approved Eliquis in 2012 for reducing the risk of stroke and systemic embolism in patients with nonvalvular atrial fibrillation. The FDA later approved it for treatment and prevention of deep vein thrombosis and pulmonary embolism, including prevention of postoperative venous thromboembolism after hip or knee replacement surgery. [1]
The product competes primarily with:
- Xarelto, or rivaroxaban, marketed by Johnson & Johnson and Bayer
- Pradaxa, or dabigatran, marketed by Boehringer Ingelheim
- Warfarin, a low-cost generic anticoagulant
- Injectable anticoagulants such as enoxaparin
Eliquis has maintained strong prescription demand because of clinical use across several indications, broad physician familiarity, twice-daily dosing, and the established direct oral anticoagulant market.
Eliquis competitive position
| Product |
Active ingredient |
Drug class |
Principal companies |
Generic status |
| Eliquis |
Apixaban |
Factor Xa inhibitor |
Bristol Myers Squibb, Pfizer |
No broad U.S. generic launch before 2028 under current settlements |
| Xarelto |
Rivaroxaban |
Factor Xa inhibitor |
Johnson & Johnson, Bayer |
U.S. generic entry expected after patent settlements in 2026 |
| Pradaxa |
Dabigatran |
Direct thrombin inhibitor |
Boehringer Ingelheim |
Generic competition is available in the U.S. |
| Coumadin and generic warfarin |
Warfarin |
Vitamin K antagonist |
Multiple companies |
Long-established generic |
| Lovenox and generic enoxaparin |
Enoxaparin |
Low-molecular-weight heparin |
Sanofi and generic manufacturers |
Generic and authorized-generic competition |
Eliquis has benefited from the clinical shift away from warfarin toward direct oral anticoagulants. That market shift supports volume, but it also makes the product one of the largest targets for generic manufacturers.
How much revenue does Eliquis generate?
Bristol Myers Squibb’s reported worldwide Eliquis sales increased from approximately $10.1 billion in 2021 to $13.3 billion in 2024. [2-5]
| Year |
Bristol Myers Squibb Eliquis revenue |
Year-over-year change |
| 2021 |
Approximately $10.1 billion |
N/A |
| 2022 |
Approximately $11.8 billion |
Approximately 17% |
| 2023 |
Approximately $12.6 billion |
Approximately 7% |
| 2024 |
Approximately $13.3 billion |
Approximately 5% |
Bristol Myers Squibb reported total 2024 revenue of approximately $48.3 billion. Eliquis therefore represented about 27% of the company’s total revenue, before considering alliance economics and product-level profitability. [5]
Pfizer reports its economic share separately from Bristol Myers Squibb. The companies’ reporting structures differ, so Pfizer’s Eliquis revenue cannot be added directly to Bristol Myers Squibb’s product-sales figure without adjustment. Pfizer’s 2024 annual report continued to identify Eliquis as one of its major alliance products. [6]
What is driving Eliquis revenue growth?
The main growth drivers are:
- Continued adoption of direct oral anticoagulants in atrial fibrillation.
- Expansion and sustained use in treatment and secondary prevention of venous thromboembolism.
- Higher diagnosis rates for atrial fibrillation and thromboembolic disease.
- Prescription persistence among older patients.
- Broad reimbursement coverage before full Medicare price negotiation takes effect.
Growth has slowed from the product’s earlier launch period. The product is mature in the U.S. and faces increasing payer pressure, but international volume and continued category expansion have supported sales.
When does Eliquis lose exclusivity?
Eliquis has two important U.S. patent layers: the original apixaban composition patent and a later formulation patent listed in the FDA Orange Book.
| U.S. patent |
General subject matter |
Listed expiration or reported term |
Commercial significance |
| US 6,967,208 |
Apixaban compound and related chemical claims |
February 23, 2026, with possible pediatric extension |
Primary composition patent |
| US 9,326,945 |
Pharmaceutical composition containing apixaban |
December 12, 2031 |
Later formulation protection and principal settlement leverage |
The FDA Orange Book is the controlling regulatory reference for patents submitted by the NDA holder, but patent listing does not by itself determine whether a patent will survive litigation or block an ANDA. [7]
The effective commercial loss-of-exclusivity date is later than the 2026 composition-patent expiration because Bristol Myers Squibb and Pfizer reached settlements with several generic applicants. Those agreements generally permit commercial launch on April 1, 2028, subject to the individual agreement terms and regulatory status of each applicant.
What formulations are protected by Eliquis patents?
The later Eliquis patent covers pharmaceutical compositions containing apixaban. Formulation claims can create a separate barrier even after expiration of the compound patent if a generic applicant relies on a formulation that falls within the listed claims.
The formulation patent is commercially important for three reasons:
- It extends listed patent protection beyond the compound patent.
- It provides a basis for Paragraph IV litigation against ANDA filers.
- It gives the branded companies leverage to negotiate delayed-entry settlements.
Generic companies can attempt to avoid infringement by designing alternative formulations, challenging patent validity, or using claim-construction arguments. The commercial value of that strategy depends on whether the FDA accepts the ANDA and whether the formulation avoids the Orange Book patent claims.
Which companies are challenging Eliquis patents?
Multiple generic drug companies filed Abbreviated New Drug Applications with Paragraph IV certifications against Eliquis patents. Publicly reported defendants and potential applicants have included major and specialty generic manufacturers such as:
- Teva Pharmaceuticals
- Mylan, now part of Viatris
- Sandoz
- Sun Pharmaceutical Industries
- Zydus Pharmaceuticals
- Hetero
- Apotex
- Micro Labs
- Sigmapharm
- Alembic Pharmaceuticals
The exact defendant group has changed as companies settled, transferred rights, or resolved individual cases. Paragraph IV certification alleges that a listed patent is invalid, unenforceable, or not infringed. The filing of a Paragraph IV notice generally triggers a 30-month stay of FDA approval under the Hatch-Waxman Act, subject to statutory exceptions and court developments.
What is the status of Eliquis Paragraph IV litigation?
Bristol Myers Squibb and Pfizer brought patent infringement actions against multiple ANDA applicants in the U.S. District Court for the District of Delaware. The cases focused on apixaban composition and formulation patents.
The principal commercial outcome has been settlement rather than immediate generic launch. Publicly reported settlements permit generic Eliquis entry beginning April 1, 2028. The settlements reduce the risk of an earlier launch while giving generic companies a defined entry date.
The settlements do not eliminate all litigation risk. A generic applicant could challenge a patent outside the settlement framework, and a court could invalidate or narrow a listed patent. The practical risk is lower than the risk indicated by the 2026 composition-patent expiration alone because most major applicants have agreed to delayed entry.
What is the Orange Book status of Eliquis?
The FDA Orange Book lists Eliquis under NDA 202155, held by Bristol-Myers Squibb Company. The listed drug contains apixaban in 2.5-milligram and 5-milligram tablets.
The principal Orange Book patent issues are:
- Composition protection associated with US 6,967,208.
- Formulation protection associated with US 9,326,945.
- Paragraph IV certifications submitted by ANDA applicants.
- Regulatory stays and settlement terms affecting approval timing.
An Orange Book patent listing does not guarantee enforceability. Generic applicants can challenge listed patents through Paragraph IV litigation, inter partes review, district-court invalidity claims, or noninfringement arguments.
How does Medicare price negotiation affect Eliquis?
Eliquis is among the first 10 drugs selected for Medicare price negotiation under the Inflation Reduction Act. The Centers for Medicare & Medicaid Services negotiated a maximum fair price of $231 for a 30-day supply, effective January 1, 2026. CMS stated that the negotiated price represents a substantial reduction from the product’s list price. [8]
The Medicare price will affect Eliquis before expected generic launch in 2028. The principal effects are:
- Lower government-reimbursed prices for Medicare Part D prescriptions.
- Reduced gross-to-net revenue in the U.S.
- Pressure on commercial payers to seek comparable discounts.
- Lower revenue per prescription even if prescription volume remains stable.
- Greater sensitivity of Bristol Myers Squibb’s 2026 and 2027 forecasts to payer mix.
The impact on total company revenue will depend on Medicare utilization, negotiated-price adoption, rebates, patient assistance, and international sales. Eliquis remains commercially important because Medicare patients represent a large portion of the atrial fibrillation population.
What generic entry scenarios exist for Eliquis?
Base case: April 2028 launch
The most likely scenario is coordinated or staggered generic entry beginning April 1, 2028. Several approved or approvable ANDAs could launch near the settlement date, producing rapid price erosion.
The first 12 months would likely involve:
- Multiple suppliers entering simultaneously.
- Pharmacy benefit manager contracting pressure.
- Rapid decline in branded U.S. prescriptions.
- Substantial reduction in net price.
- Retention of some brand demand among patients and prescribers.
Earlier-entry scenario
Earlier entry could occur if a court invalidates the later formulation patent, an applicant prevails on noninfringement, or a settlement does not bind a particular applicant. This scenario would materially increase revenue risk, but the current settlement structure reduces its probability.
Delayed-entry scenario
Entry could be delayed by FDA approval issues, manufacturing deficiencies, unresolved litigation, or commercial decisions by ANDA applicants. Multiple approved generic suppliers would make a prolonged delay unlikely once the settlement date arrives.
How strong is the Eliquis patent estate?
The Eliquis patent estate is commercially strong through the late 2020s but has limited long-term durability after generic entry begins.
| Strength factor |
Assessment |
| Composition patent |
Strong historical protection, but expiration is near |
| Formulation patent |
Important secondary barrier with a 2031 listed expiration |
| ANDA litigation |
Effective in producing delayed-entry settlements |
| Settlement control |
Strong, with major applicants reportedly tied to 2028 entry |
| Regulatory exclusivity |
No remaining new-drug exclusivity barrier comparable to the patent estate |
| Manufacturing barrier |
Moderate; apixaban tablets are technically manageable for established generic manufacturers |
| Long-term durability |
Limited after multiple generics enter |
Apixaban is a small molecule, not a biologic. Biosimilar regulation therefore does not apply. Generic manufacturers use the ANDA pathway rather than the 351(k) biosimilar pathway.
Manufacturing is unlikely to create a durable barrier comparable to those found in complex biologics, sterile injectables, or device-integrated products. The main challenges are active pharmaceutical ingredient quality, bioequivalence, tablet manufacturing, supply reliability, and regulatory approval.
How does Eliquis compare with Xarelto’s patent risk?
Eliquis and Xarelto are both large direct oral anticoagulants, but their loss-of-exclusivity timing differs.
| Factor |
Eliquis |
Xarelto |
| Active ingredient |
Apixaban |
Rivaroxaban |
| Major manufacturers |
Bristol Myers Squibb, Pfizer |
Johnson & Johnson, Bayer |
| Core U.S. patent exposure |
2026 |
Earlier generic entry expected |
| Major commercial settlement date |
April 1, 2028 for reported settlements |
Generic entry expected in 2026 under reported settlements |
| Medicare negotiated price |
$231 per 30-day supply beginning 2026 |
Also selected for negotiation |
| Generic pathway |
ANDA |
ANDA |
| Biosimilar exposure |
None |
None |
Eliquis may retain a temporary market advantage if Xarelto generics enter earlier. After Eliquis generics launch, payer formularies could shift toward lower-cost apixaban and rivaroxaban products, intensifying price competition across the category.
What licensing deals support Eliquis commercialization?
Eliquis is commercialized through the Bristol Myers Squibb-Pfizer alliance. The companies collaborated on development and share commercial economics across territories under their alliance agreements. The relationship gives Eliquis broad global commercialization capacity but also divides product economics between two companies.
For Bristol Myers Squibb, the alliance has produced a large revenue stream but reduces the portion of product economics retained by the company compared with a wholly owned product. For Pfizer, Eliquis is a major alliance asset within its cardiovascular portfolio.
The alliance also creates coordinated incentives to defend patents, negotiate settlements, manage payer contracting, and maximize revenue before generic entry.
What is the Eliquis revenue outlook?
Eliquis revenue should remain resilient through 2025, but the 2026-2028 period contains several overlapping pressures:
- Medicare negotiated pricing begins in 2026.
- The core composition patent expires in 2026.
- Commercial payers will anticipate generic entry.
- Generic settlements permit launch in 2028.
- Multiple manufacturers may enter at approximately the same time.
A reasonable commercial trajectory is:
| Period |
Expected market condition |
| 2025 |
Continued high revenue, with mature-market growth |
| 2026 |
Medicare price pressure and increasing loss-of-exclusivity discounts |
| 2027 |
Pre-generic contracting and payer migration |
| 2028 |
Generic launch and rapid U.S. net-price erosion |
| 2029 onward |
Lower branded revenue, with residual brand demand and international contribution |
The largest financial risk is U.S. revenue compression rather than complete global product disappearance. Eliquis should continue generating international and residual branded sales after generic entry, but the product’s contribution to Bristol Myers Squibb’s earnings will decline materially.
Key Takeaways
- Eliquis generated approximately $13.3 billion in Bristol Myers Squibb worldwide sales in 2024.
- It represented roughly 27% of Bristol Myers Squibb’s total 2024 revenue.
- The principal composition patent expires in 2026, while a later formulation patent is listed through 2031.
- Major generic manufacturers have settled Paragraph IV litigation with reported launch rights beginning April 1, 2028.
- Eliquis is an ANDA generic-risk product, not a biosimilar-risk product.
- Medicare negotiated pricing of $231 for a 30-day supply begins in 2026.
- Revenue should remain strong through 2025 but face progressive pressure from Medicare pricing, payer contracting, and anticipated generic entry.
- The most material downside is rapid U.S. price erosion after multiple generic manufacturers launch.
FAQs
Is apixaban the same drug as Eliquis?
Yes. Apixaban is the active ingredient in Eliquis. Eliquis is the branded product marketed by Bristol Myers Squibb and Pfizer.
Will Eliquis become generic in 2026?
The core composition patent expires in 2026, but reported settlements with major generic applicants generally permit commercial launch beginning April 1, 2028.
Is Eliquis protected by a formulation patent?
Yes. US 9,326,945 covers pharmaceutical compositions containing apixaban and has been listed with an expiration date in 2031.
Are there Eliquis biosimilars?
No. Eliquis is a chemically synthesized small-molecule drug. Competition proceeds through the FDA’s ANDA generic-drug pathway, not the biosimilar pathway.
How much revenue could Bristol Myers Squibb lose after Eliquis generic entry?
The amount depends on generic timing, price erosion, Medicare utilization, international sales, and residual brand demand. Because Eliquis represented approximately 27% of Bristol Myers Squibb’s 2024 revenue, the product is one of the company’s largest post-2027 revenue exposures.
References
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U.S. Food and Drug Administration. (2012). Eliquis approval letter and prescribing information. FDA.
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Bristol Myers Squibb. (2022). 2021 annual report. Bristol Myers Squibb.
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Bristol Myers Squibb. (2023). 2022 annual report. Bristol Myers Squibb.
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Bristol Myers Squibb. (2024). 2023 annual report. Bristol Myers Squibb.
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Bristol Myers Squibb. (2025). 2024 annual report. Bristol Myers Squibb.
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Pfizer Inc. (2025). 2024 annual report. Pfizer.
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U.S. Food and Drug Administration. (2025). Approved drug products with therapeutic equivalence evaluations: Orange Book. FDA.
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Centers for Medicare & Medicaid Services. (2024). Medicare drug price negotiation program: Negotiated prices for the first 10 drugs. U.S. Department of Health and Human Services.