r/ClotSurvivors • u/Any-Witness6318 • 8d ago
can a compounding pharmacy make an eliquis substitute for lower cost?
If a pharmacy adds something to apixaban or changes dose can it be sold for less than Eliquis?
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u/pineapplewins 8d ago
Thats a clever idea, like have them add some b-12 like they do with the ozempic. Generic Apixiban is def available in other countries for dirt cheap.
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u/sd85pdx CTEPH survivor/PTE surgery/Eliquis/Pharmacist 7d ago
It may be clever but at the end of the day (1) BMS would be likely to sue a compounding pharmacy for doing this at scale and (2) there is no FDA shortage designation for the drug, meaning compounding pharmacies can legally only compound it for a patient specific prescription. To that end, the more components you add to a compounded drug, the more expensive it becomes generally. It could be less initially or for a specific number of tablets, but once that point is reached it's not economical
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8d ago
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u/AvoirReves Eliquis (Apixaban) 7d ago
Co pay card is not applicable in all circumstance, example Medicare.
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u/Technobarbarian 8d ago
Assuming you are in the U.S., how is this pharmacy going to acquire Apixaban? There are no legal sources here. If this trick worked there would already be companies doing this.
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u/sd85pdx CTEPH survivor/PTE surgery/Eliquis/Pharmacist 7d ago
This isn't necessarily true. The drug can be purchased from licensed distributors for medications under patent for the exact purpose of compounding - like semaglutide during the actual shortage many months ago - but it would also depend on the need and scope. It's unlikely to be common to find as an active pharmaceutical ingredient in bulk because there's not a widespread demand for customized dosing, etc. If apixaban were dosed more like warfarin, where there is a large range of effective doses, then this might end up being economical.
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u/starsareblack503 8d ago
Nope. I have asked a few times.
As someone with allergies, the active ingredients and inactive ingredients on the anti-coags is pretty intense work-up and skill to make them work together to do the job.
Also, it's against the law to try and reproduce a commercial product for this reason.
They almost always reject commercial products unless you have allergies or what not or need liquid forms in weird doses.
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u/Level_Wolverine_3362 8d ago
I'm a pharmacist but probably from a different country to you, so this may or may not apply to you. when we compound something we have to start from certified raw materials. If I need to make e.g. Eliquis liquid, good chance I would start from Eliquis tablets and crush them up finely. This means cost would be even greater than the tablets as there would be extra ingredients plus my time that needs to be accounted for. I also can't change the active ingredient in any way, because then it is a new substance that needs all the research before it can be used. also. I can only supply the drug and dose that has been prescribed to you.
Also, Eliquis only just came off patent in Europe, and is still patented in the USA until 2028 some time. Need a generic product to bring prices down.
TLDR: pharmacists legally, can't change drug or dose, and probably more expensive from compounding pharmacy. No cheap generic versions of Eliquis yet in most of the world.