What Does Eliquis Cost in 2026? IRA Price, Generic Status, and All Assistance Options

Eliquis (apixaban) is a direct oral anticoagulant (DOAC) prescribed to reduce the risk of stroke and blood clots in patients with atrial fibrillation (AFib), deep vein thrombosis (DVT), and pulmonary embolism (PE). It is co-marketed by Bristol Myers Squibb and Pfizer and is the single highest-spending drug in the Medicare Part D program, accounting for roughly $16.5 billion in annual spending for 3.7 million beneficiaries before the IRA negotiated price took effect.

The Inflation Reduction Act of 2022, signed on August 16, 2022, authorized CMS to directly negotiate drug prices with manufacturers for the first time. Eliquis was one of the first 10 drugs selected for Round 1 negotiations. The negotiated Maximum Fair Price of $231 per month took effect January 1, 2026, a 62% reduction from the approximately $606 list price. For the 3.7 million Medicare patients on Eliquis, projected savings exceed $1.5 billion annually. All Medicare Part D plans, including Medicare Advantage prescription drug plans (MA-PD), are required by federal law to apply this Maximum Fair Price at the pharmacy counter. For comparison, Xarelto, another anticoagulant DOAC, also received an IRA-negotiated price reduction for 2026.

For patients without Medicare, the cost picture is very different. At the pharmacy counter without insurance or a discount program, Eliquis runs $485 to $800 per month for 60 tablets (5mg twice daily). With a free GoodRx coupon, prices drop to roughly $342 per month, which is still the highest widely available discount-card price for a 30-day supply. The Bristol Myers Squibb Patient Assistance Foundation (BMSPAF) offers free Eliquis for uninsured patients with household incomes below approximately 300% of the Federal Poverty Level, which in 2026 is $47,880 for a single-person household. The manufacturer coupon card is blocked by federal anti-kickback statute for Medicare and Medicaid patients and cannot be used with any government health program. Patients who qualify for Medicaid typically pay only $1 to $4 per prescription and should confirm their state's formulary tier. Those with both Medicare and Medicaid should review dual eligibility options.

What Eliquis Costs by Point of Pay (2026)

The price you pay depends almost entirely on WHERE you pay. The same eliquis can cost many times more at a hospital than at your local pharmacy:

Why Hospitals Charge So Much

When you are admitted to the hospital and receive Eliquis as part of your inpatient care, the cost is almost never billed as a separate pharmacy line item at the retail price. Instead, it is bundled into the Diagnosis-Related Group (DRG) payment for your hospital stay. The DRG is a flat fee Medicare pays the hospital based on your diagnosis, not the actual cost of individual drugs dispensed during the stay. Private insurers negotiate their own bundled rates separately. Patients with no insurance face the hospital's chargemaster rate, which can be 2 to 3 times the Medicare DRG equivalent.

For patients transitioning from an inpatient hospital stay to outpatient management of AFib, DVT, or PE, the cost situation shifts. Once discharged, Eliquis is covered under Medicare Part D rather than Part A. That is where the IRA-negotiated $231 per month Maximum Fair Price applies. Patients who assume the outpatient prescription will cost the same as the inpatient DRG rate are often surprised by sticker shock, especially if they have not yet enrolled in a Part D plan. Patients discharged without Part D coverage should contact 1-800-MEDICARE immediately to explore enrollment options.

Because no generic apixaban is on the US market as of 2026, there is no low-cost fallback at the pharmacy. Warfarin (generic Coumadin) is the older anticoagulant that costs $4 to $15 per month and requires regular INR blood monitoring, but it has different drug-interaction and safety profiles compared to Eliquis. The choice between warfarin and a DOAC like Eliquis is a clinical decision, not purely a cost decision. Patients who cannot afford Eliquis should ask their prescriber whether warfarin is clinically appropriate before stopping anticoagulation therapy entirely, as discontinuing without a clinical plan carries significant stroke and clot risk. The Extra Help program reduces Medicare Part D cost-sharing to $12.65 per fill for income-eligible patients who cannot afford the $231 MFP.

Patient Assistance Programs

Bristol Myers Squibb runs two assistance pathways for Eliquis. The BMS Patient Assistance Foundation (BMSPAF) provides free Eliquis to uninsured patients whose household income falls below approximately 300% of the Federal Poverty Level. A separate Eliquis 360 Support direct-to-patient purchase option is available for uninsured patients at a discounted price. IMPORTANT: If you have Medicare, Medicaid, TRICARE, or VA coverage, federal anti-kickback statute (42 U.S.C. Section 1320a-7b) prohibits using manufacturer copay coupons. Medicare Part D patients use the IRA-negotiated $231 Maximum Fair Price instead. Medicare patients who cannot afford $231 per month should apply for Part D Extra Help through Social Security at 1-800-772-1213, which reduces Eliquis cost to the 2026 brand copay of $12.65 per fill.

Medicare Part D

If you have Medicare Part D, Eliquis is covered at the IRA-negotiated Maximum Fair Price of $231 per month effective January 1, 2026. This price applies at any Part D network pharmacy, regardless of which plan you have. Your actual out-of-pocket cost depends on your plan's copay or coinsurance structure applied to the $231 MFP, not the $606 list price. All out-of-pocket costs count toward the 2026 Part D annual OOP cap of $2,100. Once you reach that cap, you pay $0 for Eliquis and all other covered drugs for the rest of the year. If your Part D plan charges more than $231 for a 30-day Eliquis fill in 2026, contact your plan's member services and request they apply the Maximum Fair Price; plans are legally required to honor it.

Patients who qualify for the Part D Extra Help (Low Income Subsidy) program pay significantly less. In 2026, the Extra Help copay for brand-name drugs like Eliquis is $12.65 per fill. Extra Help is available for Medicare beneficiaries with incomes at or below 150% of the Federal Poverty Level (approximately $23,940 for a single person in 2026). Apply for Extra Help through Social Security at 1-800-772-1213 or at ssa.gov. During a hospital inpatient stay, Eliquis is bundled into the Part A DRG payment and is not separately covered under Part D. The Part D MFP applies only to outpatient prescription fills at retail pharmacies.

Common Eliquis Billing Errors

Eliquis is an oral tablet dispensed at the pharmacy, so billing errors differ from those involving injectable drugs. The most common issues involve formulary tier coding and IRA Maximum Fair Price application failures since January 2026:

• Part D plan charging coinsurance based on the $606 list price instead of the 2026 MFP of $231, resulting in patient overpaying by as much as $375 per fill; request the plan apply the Maximum Fair Price and file a coverage determination dispute if declined
• Pharmacy dispensing Eliquis under Medicare Part B outpatient billing instead of Part D; Eliquis oral tablets are a Part D drug and are not covered under Part B; if you see a Part B claim for oral Eliquis on your Medicare Summary Notice, that is a billing error
• Prior authorization denied based on formulary non-preferred status when the IRA MFP overrides tier restrictions for Medicare Part D patients on all Part D formularies effective 2026-01-01
• Inpatient hospital billing Eliquis as a separate line-item charge during an inpatient stay rather than bundling into the DRG payment; request an itemized bill and compare against the hospital's CMS price transparency file
• Out-of-pocket costs not being credited toward the $2,100 annual Part D cap when switching pharmacies or plans mid-year; Medicare has a system to track cumulative OOP spending, and all covered costs at any Part D network pharmacy count toward the cap
• Manufacturer copay card used incorrectly by a pharmacist for a Medicare or Medicaid patient; this violates federal anti-kickback statute (42 U.S.C. Section 1320a-7b) and can result in clawback of the discount and potential legal liability; contact your plan immediately if this occurred

Frequently Asked Questions