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jobrien60
Contributor ⭐
October 2, 2026
Question

Medicare 2027 Negotiated Drug Prices

I recently retired and signed  up for a Medicare Advantage plan in 2026.  I take Xarelto 20 mg and through government negotiated pricing it was affordable.  However, it appears Xarelto has been removed from 2027 Medicare negotiated pricing for 2027.  From what I gathered this was done because Xarelto 2.5 mg went generic and the government negotiated pricing terms/conditions removed drugs from the negotiated pricing if they went generic, regardless of the dosage.  Thus, if on any dosage other than 2.5 mg you will pay substantially more for your Xarelto in 2027. 

I’ve heard many people get generic Xarelto (Rivaroxaban) from Canada, but it appears US government will be tightening down on this is this making it difficult to do this going forward.

Thus, I’m curious what other options might be available to get Xarelto at a reasonable price if on Medicare? 

Thanks!

    12 replies

    RandolphW111094
    Contributor ⭐
    October 26, 2026

    I have been prescribed Xarelto 20mg since 2016 when I was diagnosed with AFIB. I have an ablation in late 2016 and was advised to remain on Xarelto. I am enrolled in Original Medicare….with a Prescription D drug plan. When I went in to check coverage for 2027 I found that none of the 8 plans available to me will cover Xarelto 20mg tablet. And even more insulting….I found there is NO GENERIC available for Xarelto 20mg. If I purchased the same Xarelto via the market price….it would be $2,022.00 for a 90 day supply…..nearly $9,000.00 for 2027.
    I contacted my Primary physician, and I will be switching to Eliquis at the beginning of 2027.

      MaryH657753
      Contributor ⭐
      October 25, 2026

      If you want to stay on Xarelto you can go directly through the manufacturer.  The out-of-pocket cost for the year for 20mg  is $2,364.  However, none of that gets counted towards the annual part D deductible because it isn’t going through insurance.  And, their disclaimer says they can stop the program at any time.  I found the link through TrumpRx, seemingly a “gift” from Donald but to me it just seems like a racket!  Here are the details:  Johnson & Johnson Innovative Medicine manages direct patient orders through their direct-to-patient program, J&J Direct. J&J Direct will guide you through program eligibility, terms and conditions for participation.

      For support, call J&J Direct at 1-855-522-3241 between 9:00 AM – 9:00 PM ET, Monday through Friday.

       

        g561253m
        Contributor ⭐
        October 8, 2026

        Eliquis is now the drug of choice.  Only difference is you take Eliquis twice a day.  My doc told me the switch is easy, you end Xarelto and following day start Eliquis.  Eliquis has always been a few bucks more, but not much different.

         

          TRL1111
          Community Champion ⭐
          October 8, 2026

          Eliquis is now the drug of choice.  Only difference is you take Eliquis twice a day.  My doc told me the switch is easy, you end Xarelto and following day start Eliquis.  Eliquis has always been a few bucks more, but not much different.

           

          Before, you said, “Will be forced to switch to Eliquis. What a shame how this country treats older Americans.”  And somehow invoked Biden.  But 12 hours later it’s an easy switch to a drug your doctor prefers.

          g561253m
          Contributor ⭐
          October 8, 2026

          None of the Medicare D drug plans include Xarelto.  I take the 20mg.  The 2.5mg is available as a generic.  The other does are not generic at this time.  Eliquis and Xarelto were two of the largest selling drugs that Medicare reimburses for.  Will be forced to switch to Eliquis.  What a shame how this country treats older Americans.  I guess the manufacturer is trying to make the most money.  So much for Biden’s negotiated pricing.

           

            TRL1111
            Community Champion ⭐
            October 8, 2026

            Why don’t you just take more of the 2.5mg generic Xarelto to meet your 20mg dosage?  There’s another thread about this very thing, but PLEASE ignore the AI answer.  It was hallucinating.

              WendyG268754
              Contributor ⭐⭐
              October 8, 2026

              The way the drug gets absorbed is different between the two dosages. We got a shock for my dad’s plan set for next year. This year he paid around $600 for all of his medications combined. Next year because Xarelto will no longer be covered, the estimate is around $9500! I don’t get how Medicare can say that there is a generic available when that’s not the case for anyone who has to take the higher dosages.

                SummerOnTheWay1
                SummerOnTheWay1
                October 2, 2026

                ​@jobrien60 , you may want to contact your Local Office Of Aging (LOA). It is free & over the years they have answered my questions and helped me with my Medicare Setup.

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