The news: Pfizer and Bristol Myers Squibb will launch a direct-to-patient channel to sell their blockbuster blood thinner Eliquis at a reduced cash-pay price.

• The Eliquis 360 Support program will launch in September for uninsured and self-pay patients at a monthly cost of $346, 43% lower than its $606 list price.
• The companies decided to launch the direct service after discussions with the Trump administration, the Wall Street Journal reported.

Digging into the details: Eliquis is an expensive but more effective alternative to generic warfarin for patients with certain cardiovascular conditions. The drug was included on the first list of Medicare-negotiated drugs under the Inflation Reduction Act in 2023.

• Eliquis generated $13.3 billion in global sales last year, with the US accounting for $9.6 billion, per BMS reporting. It was BMS’ highest revenue-generating drug.
• 90% of US Eliquis prescriptions are covered by commercial or Medicare insurance.
• Medicare spent $16.5 billion for 3.7 billion US patients on the drug between June 2022 and May 2023, per CMS.
• The IRA Medicare-negotiated price of $231 is set to kick in next year, which is also the year Eliquis is set to lose patent protection in the US.

Zooming out: The move comes as the Trump administration is pressuring drugmakers to drop prices.

• Trump pledged a 200% tariff threat on pharma products last week with a caveat of a year or longer to implement.
• An executive order in May instructed pharma companies to equalize US drug prices with the rest of the world with promised delivery of specific price targets to drugmakers within 30 days.

Our take: Pfizer and Bristol Myers Squibb have anticipated the Eliquis patent loss and sales drop for years as part of the typical branded drug cycle. We see the new direct sales platform launch not as a play for new revenues, but rather a negotiating nod to the Trump administration. Only 10% of Eliquis patients are uncovered by insurance, so it’s a small market to court as a revenue-driving ploy. However, Trump has made it clear he’s open to using any levers possible to force lower drug prices, pushing pharma companies to offer good faith options and concessions.

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