Bristol Myers Squibb and Pfizer said they will begin selling their top-selling blood thinner Eliquis directly to U.S. patients at a cash price of $346 for a 30-day supply, roughly 40% below the medicine’s $606 list price. The service, offered through the companies’ Eliquis 360 Support website, will open on 8 September and ship prescriptions to all 50 states and Puerto Rico. The direct-to-patient model bypasses pharmacy benefit managers and insurers and is aimed at the uninsured, under-insured and people who pay out of pocket. The announcement follows growing pressure from the Trump administration, which has threatened broader action to align U.S. drug prices with those in other wealthy nations. Analysts said the discount, while sizeable, still exceeds both the average $38 monthly out-of-pocket cost for commercially insured users and the $231 price Medicare negotiated under the Inflation Reduction Act that takes effect next year. Eliquis has been prescribed to more than 15 million Americans and generated about $11.4 billion in global sales in 2024. With key patents set to expire in 2026, the programme adds the cardiovascular blockbuster to a small but expanding list of brand-name drugs—such as Eli Lilly’s Zepbound and Novo Nordisk’s Wegovy—now offered through manufacturer-run online pharmacies designed to give patients a clearer view of net prices while fending off political scrutiny.