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What Makes Anti-Coagulants like Xarelto Drug so Expensive?

xarelto drug

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The scary thing about strokes is that it takes so little time to have major long-term brain damage done if you have one. Anyone who has their increased risk of having a stroke identified by their doctor should consider themselves fortunate, as strokes have taken away the quality of life for far too many people. Blood thinner (anticoagulant) medications are often an integral part of stroke prevention for people with that risk, and the Xarelto drug and Eliquis Apixaban are too of the better medications for preventing blood clots. But why are they so darn expensive?

Xarelto medications is super pricey, especially for anyone who doesn’t have extended healthcare coverage that lowers the cost of prescription drugs for them. Same goes for Eliquis Apixaban, but the first thing to make clear is that these are just two of literally hundreds of drugs that Americans have difficulty affording a lot of the time. There are many reasons why most prescription drugs are overly expensive in America. While there is reason to hope that will change in the future, the reality is people are not going find lower prices on medication anytime soon.

However, it’s true that ever greater numbers of people are ordering drugs online from Canada to get a better price on their medications, and both the Xarelto drug and Eliquis Apixaban are drugs that you can order from Canadian pharmacies. Something to consider if you’re one of the many who find it hard to afford your prescription meds, whether they’re anticoagulant medications or otherwise.

Now, let’s really look into why Xarelto and Eliquis – among many others – are extremely expensive drugs for people.

Starts with Pricing Monopoly

There’s no disputing the fact that the single biggest reason any expensive drug has an obscene cost attached to it is because of the pricing monopoly on drugs that has been a fixture of the US pharma care industry for as long as anyone can remember. The United States is the only country in the world that allows drug manufacturers to set their own prices as freely as they please. Now when you consider that the country is the very bastion of free-market capitalism, it shouldn’t come as much of a surprise that many of these manufacturers are going to be looking to make as much profit as they can on the Xarelto drug.

Now we did mention that there is reason to hope that consumer drug prices may become lower in the future. For that to happen, there needs to a be a willingness on the part of the US Federal Gov’t to make it so that the US gets in line with other countries that legislate against pricing monopolies for drug manufacturers. Whether that will apply to Xarelto drug or Eliquis Apixaban even if does happen remains to be seen, but for now the price will be what the manufacturer decides it will be.

Role of Individual Health Plans and PBMs

There are two other major factors that go into the high cost many consumers have to pay for their Rx drugs. We’ve talked about how drug manufacturers establish the ‘list’ price as freely as they please, but then that list price is adjusted one way, or another based on the individual’s health plan benefits (and of course assuming they have health plan benefits in the first place.

In most cases, unfortunately, the consumer is required to pay more out of pocket based on what their plan dictates for them. If the individual needs a medication like Xarelto drug or Eliquis Apixaban that has a higher list price to begin with, then they’re going to have much higher out-of-pocket costs too. One thing that you do want to know is that many plans will pay 100% of the cost for the generic equivalent of a drug, but often they’ll only cover 50% for the branded version of that same medication.

Finally we have the role of PBMs, which is short for pharmacy benefit managers who work for the health care plan providers. They play a role in the end user cost for drugs in the USA as they develop their plan’s formulary and negotiate with drug companies for a better price. Unfortunately, the long and short of it here is that most of the time they don’t do a whole lot of negotiating. It’s for all these reasons that Xarelto drug and Eliquis Apixaban – among many other Rx medications – are as expensive as they are.


IMPORTANT NOTE: The above information is intended to increase awareness of health information and does not suggest treatment or diagnosis. This information is not a substitute for individual medical attention and should not be construed to indicate that use of the drug is safe, appropriate, or effective for you. See your health care professional for medical advice and treatment.


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