BMS, Pfizer take DTC route for blood thinner Eliquis

Bristol Myers Squibb and Pfizer have launched an online programme to sell their blockbuster anticoagulant Eliquis directly to patients, following in the footsteps of Eli Lilly and Novo Nordisk in a shake-up of the US pharma market.

The direct-to-consumer (DTC) platform – called Eliquis 360 Support – will offer Eliquis (apixaban) to patients who pay for the drug out-of-pocket with a 40% or greater discount to its current list price, providing a new option for uninsured, underinsured, or self-pay patients.

Eliquis will be provided through the programme at $346 per month, a 43% reduction on its list price of $606 per month, from 8th September.

The move ties in with an emerging trend in the US pharma market to sell drugs directly to patients – if they have a prescription of course – and sidestep other players in the US medicines supply chain, including retail pharmacies and intermediary companies.

Some critics of the approach – including the American College of Physicians – have pointed to the potential for a breakdown in the physician-patient relationship, while others have raised concerns about conflict of interest given the potential for telehealth providers favouring one company's brands over another.

Just this week, US lawmakers published the outcome (PDF) of an investigation into the Lilly and Pfizer programmes, concluding that "these novel relationships between drug companies seeking to sell their medications, and the telehealth companies hand-picked by these pharmaceutical giants, appear intended to steer patients toward particular medications."

Lilly kicked off the new model with the launch of its LillyDirect service last year, initially for a limited list of medicines for diabetes, obesity and other conditions, and has gradually expanded the range of products available through the platform.

Novo Nordisk quickly followed suit with its NovoCare Pharmacy channel, viewing it like Lilly as a way to fend off competition from compounders of widely copied diabetes and obesity shots. Pfizer joined in last summer with Pfizer4All, offering diagnostic tests, various medicines and vaccines, and telehealth support, and has now extended its DTC offering with the BMS alliance.

Eliquis is a massively important product to both companies, with $13.3 billion in combined sales, but is among the first tranche of products undergoing Medicare pricing negotiations and will see its list price reduced to $231 per month next year. It is also due to lose US patent protection in 2028.

"Eliquis is relied upon by millions of Americans daily, and this programme will provide a simple and transparent way to access it," said BMS chief executive Chris Boerner.

"This programme passes more savings directly to patients and demonstrates our continued focus on identifying innovative solutions that foster the best outcomes for each individual while prioritising access to care."

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