Pradaxa and cost

As with all medications, the cost of Pradaxa can vary. Factors that may affect the price you’ll pay include:

• your treatment plan
• your insurance coverage
• the pharmacy you use
• whether Pradaxa has a savings program (see the “Financial and insurance assistance” section below)

To find out what the cost of Pradaxa will be for you, talk with your doctor, pharmacist, or insurance provider.

Note: If you have insurance, your insurance company may require prior authorization before it covers Pradaxa. This means the company and your doctor will discuss Pradaxa in regard to your treatment. The insurance company will then determine whether the medication is covered. If a drug requires prior authorization but you start treatment without the prior approval, you could pay the full cost of the medication. You can ask your insurance company whether Pradaxa requires prior authorization.

The active ingredient of Pradaxa is dabigatran. The capsule form of the drug is available as the generic drug dabigatran. A generic drug is considered to be as safe and effective as the original drug. And generics tend to cost less than brand-name drugs. Currently, Pradaxa oral pellets are not available in a generic version.

If your doctor has prescribed Pradaxa and you’re interested in taking dabigatran instead, talk with your doctor. They may have a preference for one version or the other. You’ll also need to check with your insurance provider, as it may only cover one or the other.

To find out how the cost of this generic drug compares with the cost of Pradaxa, talk with your doctor, pharmacist, or insurance provider.

WHY ARE COSTS DIFFERENT FOR BRAND-NAME DRUGS VS. GENERIC DRUGS?

Brand-name drugs can be expensive because of the research needed to test their safety and effectiveness. The manufacturer of a brand-name drug can sell it for up to 20 years. When the brand-name drug’s patent expires, multiple manufacturers can create generic versions. This marketplace competition may lead to lower costs for generics. Also, because generics contain the same active ingredients as brand-name drugs, they don’t require the same costly testing.

Here are answers to some frequently asked questions about drug cost and Pradaxa.

Is Pradaxa covered by Medicare?

Medicare will typically cover the cost of Pradaxa. However, talk with your Medicare representative to be sure the drug is covered by your plan.

Your cost depends on the type of coverage you have, your treatment plan, and the pharmacy you use. To find out what your exact cost will be, talk with your pharmacist or Medicare provider.

The drug manufacturer provides a copay calculator to help estimate your Pradaxa cost with Medicare based on criteria such as your location. To use this tool, visit the drugmaker’s website.

How does the cost of Pradaxa compare with the cost of Eliquis?

Pradaxa and Eliquis are brand-name medications prescribed for some similar uses, but they are different drugs. Pradaxa’s active drug is dabigatran. Eliquis’s active drug is apixaban.

The cost of Pradaxa and Eliquis is usually similar. However, your cost for either of these drugs depends on certain factors, such as:

• your treatment plan
• whether you have health insurance and the type of plan you have
• the pharmacy you use
• whether your health insurance covers one drug over the other
• the retail price of each drug

Talk with your pharmacist or insurance provider about the price you’ll pay for Pradaxa and Eliquis. Your doctor can also discuss the cost difference and recommend which drug option is right for you.

Your pharmacist and doctor can advise if there are cost savings options available for these medications. Also, see the “Financial and insurance assistance” section below for ways to save on Pradaxa.

If you take Pradaxa long term, you may be able to lower its cost in the following ways.

Getting a 3-month supply

You may be able to get a 90-day supply of Pradaxa. If approved by your insurance company, getting a 90-day supply of the drug could reduce your number of trips to the pharmacy and help lower the cost. If you’re interested in this option, check with your doctor, pharmacist, or insurance provider.

Using a mail-order pharmacy

Pradaxa may be available through a mail-order pharmacy. Using this type of service may help lower the drug’s cost and allow you to receive your medication without leaving home. Some Medicare plans may help cover the cost of mail-order medications. You may also be able to get a 90-day supply of the drug via mail order.

If you don’t have health insurance, talk with your doctor or pharmacist. They may be able to suggest online pharmacy options that could work for you.

If you need financial support to pay for Pradaxa, or if you need help understanding your insurance coverage, help is available. For example:

• A Pradaxa Savings Card is available for certain people with health insurance. For more information and to find out if you’re eligible for support, visit the program website.
• A program called Inside Rx is available for some people that may have trouble paying their Pradaxa copay in certain cases. For more information and to find out if you’re eligible for support, visit the program website.
• Some websites provide details about drug assistance programs, ways to make the most of your insurance coverage, and links to savings cards and other services. Two such websites are:
  • Medicine Assistance Tool
  • NeedyMeds

To learn more about saving money on prescriptions with or without insurance, check out this article.

Now that you’ve learned about cost and Pradaxa, you may still have some questions. Talk with your doctor or pharmacist, who can provide personalized guidance about cost issues related to Pradaxa. But if you have health insurance, you’ll need to talk with your insurance provider to learn the actual cost you would pay for Pradaxa.

Here are some other resources you may find helpful:

• Medicare drug coverage. To learn about Medicare coverage for drugs, see these articles about Medicare Prescription Drug Plans, drug coupons and Medicare, and the Medicare drug list.
• More details. For details about other aspects of Pradaxa, refer to this article.
• Dosage. Learn about Pradaxa and dosage by viewing this article.
• Side effects. For details about Pradaxa’s side effects, see this article. You can also look at the Pradaxa prescribing information for oral capsules and oral pellets
• Information about blood conditions. For more information about your condition, see our cardiovascular hub and list of blood/hematology articles.

Disclaimer: Medical News Today has made every effort to make certain that all information is factually correct, comprehensive, and up to date. However, this article should not be used as a substitute for the knowledge and expertise of a licensed healthcare professional. You should always consult your doctor or another healthcare professional before taking any medication. The drug information contained herein is subject to change and is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. The absence of warnings or other information for a given drug does not indicate that the drug or drug combination is safe, effective, or appropriate for all patients or all specific uses.