Blood thinner cost: how to pay less for Eliquis, Xarelto and warfarin

Medicare’s negotiated prices

Under the Medicare Drug Price Negotiation Program, Eliquis (apixaban) and Xarelto (rivaroxaban) were among the first 10 drugs with negotiated prices, which started January 1, 2026 (CMS). CMS says the negotiated prices are 56% below the 2023 list price of a 30-day supply of Eliquis and 62% below Xarelto’s (CMS). CMS’s price file lists $231 for a 30-day supply of Eliquis in 2026 (CMS).

• That isn’t your copay. The negotiated price is the price Medicare and the drug company agreed on (CMS). What you pay still depends on your plan’s deductible, copays or coinsurance (Medicare.gov).
• Xarelto is leaving the program. CMS deselected Xarelto in October 2025, and it comes off the negotiated-price list on January 1, 2027 (CMS). CMS deselects a drug when, for example, an FDA-approved generic is on the market (CMS). Ask your pharmacist whether a generic rivaroxaban is available in your strength and what it costs on your plan.

If you have Medicare

• Out-of-pocket costs for covered Part D drugs are capped at $2,100 in 2026 and $2,400 in 2027 (Medicare.gov).
• If you have limited income, ask about Extra Help with drug costs (Medicare.gov). You can apply through Social Security.
• If you buy a drug with a discount card instead of your plan, it doesn’t count toward your out-of-pocket limit (Medicare.gov). During open enrollment, check that next year’s plan covers your blood thinner. See our Medicare open enrollment guide.

Brand vs. generic

The FDA approved the first generics of Eliquis, apixaban tablets of 2.5 mg and 5 mg, on December 23, 2019 (FDA). The FDA says approved generics work the same way as the brand and usually cost less (FDA). Approval doesn’t always mean a generic is on pharmacy shelves, so ask your pharmacist what’s available and what it costs.

Warfarin: cheaper pills, more tests

Warfarin is an older blood thinner that’s widely available as a generic. It comes with extra costs and steps that newer drugs usually don’t:

• Regular blood tests. MedlinePlus says your doctor will order regular blood tests, called PT/INR, to check how warfarin is working (MedlinePlus). Ask what each test costs on your plan.
• Steady diet. Eat consistent amounts of foods that contain vitamin K (MedlinePlus).
• Bleeding risk. MedlinePlus says warfarin can cause serious bleeding, and the risk is higher for people 65 and older (MedlinePlus).

Once you add tests and visits, the cheapest pill isn’t always the cheapest choice. Which drug is right is a medical decision, so ask your doctor about cost instead of switching on your own.

Avoid costly mistakes

• Tell every doctor, surgeon and dentist that you take a blood thinner before any procedure (MedlinePlus).
• Put refill dates on your calendar so you can compare prices ahead of time instead of running out (MedlinePlus).

If you’re uninsured or underinsured

• Compare a discount card price for your drug with your copay. See how discount cards work.
• HRSA-funded health centers offer care on a sliding fee based on income. Find one near you.
• Illinois open enrollment for 2027 plans runs November 1, 2026 to January 15, 2027 at Get Covered Illinois.

On other daily medicines too? See our generic blood pressure and cholesterol guide and our prescriptions hub.