In 2011, Johnson & Johnson introduced its blood thinner Xarelto and in 2013, Bristol Myers Squibb followed suit by introducing Eliquis. While blood thinners have been around for years, Xarelto and Eliquis were different because they were less risky and did not require routine lab monitoring.
When the drugs were introduced, the list prices were $218 and $250, respectively. However, by January 2022, the prices for the drugs had increased to $516 and $529. According to a report from Patients for Affordable Drugs, the price increases of these prescriptions has outpaced the rate of inflation annually and Medicare Part D has spent over $46 million on the two prescriptions since 2015.
The report further notes that there are no generic competitors for Xarelto and Eliquis and that instead of undercutting each other’s prices to gain market share, the companies have increased prices “in lockstep over the past decade,” thereby allowing the companies “to extract increasing amounts of profit.”
The report notes that on August 1, 2015, both prescriptions were priced at $314 for a month’s supply. On August 5, 2015, the price of Xarelto was increased to $333 and three weeks later, Eliquis’ price increased to $333. Then, in Spring 2016, Eliquis’ price was increased from $333 to $359 and five days later, Xarelto’s price was increased to $359. In Winter 2017, both prescriptions increased price from $359 to $388.
Anticompetitive Behavior
The report also makes reference to patent applications made by Johnson & Johnson and Bristol Myers Squibb/Pfizer for the two prescription drugs. According to the report, Johnson & Johnson applied for 49 patents on Xarelto (30 of them granted) and Bristol Myers Squibb/Pfizer applied for 48 patents on Eliqius (27 of them granted).
In 2017, about a dozen generics started the process of seeking FDA approval at which time Bristol Myers Squibb/Pfizer served the companies with lawsuits to delay their entry. In 2019, two generics were approved, but due to ongoing patent litigation, it’s possible that they will not hit the market until 2026.
Congressional Response
Legislation
In response to this situation, the United States Congress recently passed the Inflation Reduction Act. Part of the legislation would allow Medicare to negotiate lower prices for certain prescriptions, including Xarelto, and would prevent price increases from outpacing the rate of inflation.
Request for Investigation
On top of legislation, Senator Amy Klobuchar and Representative Amy Porter have sent a letter to the Department of Justice and Federal Trade Commission, asking them to investigate whether the price hikes were illegal and done in concert with each other.
“The prices for these two competing products have risen every year since they entered the market at a rate far outpacing inflation, without any meaningful improvements to the medications or any apparent increase in production costs,” the congresswomen wrote. They conclude their letter by saying, “This pattern of lockstep price increases and the general lack of competitive behavior exhibited by these drug sellers raises concerns regarding potential unlawful conduct. We urge your agencies to evaluate the state of competition in this drug market and whether these companies’ pricing practices may have violated federal antitrust laws.”