Apixaban — what it treats, what it costs

What it should cost to fill

Strength	Cash price	With a discount card
2.5 mg tablet (twice daily)	$540 – $690	$470 – $610
5 mg tablet (twice daily)	$550 – $700	$480 – $620

Typical retail ranges, not quotes. What you are charged depends on the pharmacy and on how the claim is processed — which is exactly why it is worth asking.

Where the money goes

Generic apixaban has been approved but is not yet widely available in the US. Ask your pharmacist whether it has reached them — this is the drug where that answer will change soonest.
The manufacturer runs a copay card that can cut a commercial-insurance copay substantially. It cannot be used with Medicare or Medicaid.
On Medicare Part D, the annual out-of-pocket cap now limits what this can cost you across a year. Ask your plan what you have already spent.

What else there is

Not recommendations. The tradeoff matters more than the name, and it is the part a prescriber will want to talk about.

Rivaroxaban (Xarelto)Same class

Also brand-only and similarly priced. Once daily rather than twice, which suits some people better.

Warfarin (Coumadin)Different class

Pennies a month, and the only option for mechanical heart valves. The cost is real but different: regular blood tests, dose changes, and food and drug interactions. Many people are on apixaban precisely to avoid that, so this is a genuine trade-off, not an obvious saving.

Worth asking

Is generic apixaban available yet, and can you write for it?
Given my situation, would warfarin be reasonable, or is there a specific reason I am on this one?

Before you change anything. Never skip doses or stop a blood thinner to save money. The risk is a stroke or a clot. If you cannot afford it, say so — there are assistance programmes.