Help paying · Medicare negotiated price · pharmacy cost · cycle 2026
Xarelto (rivaroxaban): where help paying exists, what Medicare negotiated and what pharmacies pay
3 assistance programs list rivaroxaban, each with its income ceiling and when we read it. Medicare's negotiated price for a 30-day supply is $197 (in force since January 1, 2026). CMS's file lists all 19 packages of Xarelto as deselected from the negotiation program, with the negotiated price ending December 31, 2026. After that date there is no negotiated price for them. The file does not say why. Per unit, the negotiated price is 35% of NADAC, the pharmacy acquisition benchmark. 2 non-manufacturing label changes are dated in the last 12 months in the FDA's file. ClinicalTrials.gov lists 67 recruiting trials that name rivaroxaban.
One package, side by side
Price per unit for one package of Xarelto. The negotiated price applies to Medicare Part D; NADAC is a survey of what retail pharmacies pay to buy the drug.
Swipe to read across
Every package we can price
Per-unit prices (per mL, as the files state). "Scheduled" is a price the CMS file already dates for the future.
| NDC | Product | Unit | Negotiated now | Scheduled | NADAC | Share |
|---|---|---|---|---|---|---|
| 50458-0575-01 | XARELTO ORAL SUSPENSION | ML | $1.33 | ends 2026-12-31 | $3.76 | 35% |
| 50458-0577-01 | XARELTO (rivaroxaban) | EA | $3.44 | ends 2026-12-31 | $9.78 | 35% |
| 50458-0577-10 | XARELTO (rivaroxaban) | EA | $3.44 | ends 2026-12-31 | $9.78 | 35% |
| 50458-0577-18 | XARELTO (rivaroxaban) | EA | $3.44 | ends 2026-12-31 | $9.78 | 35% |
| 50458-0577-60 | XARELTO (rivaroxaban) | EA | $3.44 | ends 2026-12-31 | $9.78 | 35% |
| 50458-0578-01 | XARELTO, 15MG TABLETS, HUD, 10 count BLISTER PACK (Inner NDC) | EA | $6.88 | ends 2026-12-31 | $19.53 | 35% |
| 50458-0578-10 | XARELTO (Rivaroxaban) Tablets 15mg, HUD (2x5) x 10, 6 count | EA | $6.88 | ends 2026-12-31 | $19.53 | 35% |
| 50458-0578-30 | XARELTO (Rivaroxaban) Tablets, 15mg, 30's, 24 count | EA | $6.88 | ends 2026-12-31 | $19.53 | 35% |
| 50458-0578-90 | XARELTO (Rivaroxaban) Tablets, 15mg, 90's, 24 count | EA | $6.88 | ends 2026-12-31 | $19.53 | 35% |
| 50458-0579-01 | XARELTO, 20MG TABLETS, HUD, 10 count BLISTER PACK (Inner NDC) | EA | $6.88 | ends 2026-12-31 | $19.54 | 35% |
| 50458-0579-10 | XARELTO (Rivaroxaban) Tablets 20mg, HUD (2x5) x 10, 6 count | EA | $6.88 | ends 2026-12-31 | $19.54 | 35% |
| 50458-0579-30 | XARELTO (Rivaroxaban) Tablets, 20mg, 30's, 24 count | EA | $6.88 | ends 2026-12-31 | $19.54 | 35% |
| 50458-0579-89 | XARELTO (Rivaroxaban) Tablets, 20mg, 1000's | EA | $6.88 | ends 2026-12-31 | $19.54 | 35% |
| 50458-0579-90 | XARELTO (Rivaroxaban) Tablets, 20mg, 90's, 24 count | EA | $6.88 | ends 2026-12-31 | $19.54 | 35% |
| 50458-0580-01 | XARELTO, 10MG TABLETS BLISTER PACK, HUD, 10 count BLISTER PACK | EA | $6.87 | ends 2026-12-31 | $19.52 | 35% |
| 50458-0580-10 | XARELTO 10MG HUD (2X5)X10 | EA | $6.87 | ends 2026-12-31 | $19.52 | 35% |
| 50458-0580-30 | XARELTO 10MG 30S 24 COUNT | EA | $6.87 | ends 2026-12-31 | $19.52 | 35% |
| 50458-0580-90 | XARELTO 10MG 90S | EA | $6.87 | ends 2026-12-31 | $19.52 | 35% |
| 50458-0584-51 | Xarelto (Rivaroxaban) Starter Pack | EA | $6.85 | ends 2026-12-31 | $19.47 | 35% |
When could a generic arrive
Each date below is an upper bound from listed patent and exclusivity dates, not a forecast of when a generic will launch. Basis: latest of all listed patent and exclusivity expiries in this Orange Book edition; an upper bound from listed dates only, not a forecast of launch (litigation, settlements, delisting, tentative approvals and 180-day status are not modelled).
| Application | Product | Latest listed patent expiry | Latest listed exclusivity expiry | Latest of the two | Set by |
|---|---|---|---|---|---|
| NDA022406 | Xarelto (rivaroxaban), Xarelto (rivaroxaban) Starter Pack, Xarelto (rivaroxaban) Tablets 15mg, Hud (2x5) X 10, 6 Count, Xarelto (rivaroxaban) Tablets 20mg, Hud (2x5) X 10, 6 Count and 8 more | August 17, 2034 | none listed | August 17, 2034 | patent 9539218 with its pediatric extension; 6 dated entries listed |
1 application behind this drug has no Orange Book dates in the edition we read.
Source: FDA Orange Book data files, edition September 2026, read November 7, 2026; patent listings are as submitted by applicants and not verified by FDA. FDA data file.
Medicare Part D spending
CMS's Medicare Part D spending dataset reports gross spending on Xarelto of $6.23 billion in 2024, across 6,660,246 claims and 1,321,019 beneficiaries. CMS's dataset states spending is gross drug cost and does not reflect manufacturers' rebates or other price concessions. Spending is the total paid by Medicare, plans and beneficiaries for the drug's claims, not what a patient pays.
| Year | Gross spending | Claims | Beneficiaries | Average spending per claim |
|---|---|---|---|---|
| 2024 | $6.23 billion | 6,660,246 | 1,321,019 | $936 |
| 2023 | $6.31 billion | 6,654,162 | 1,324,165 | $948 |
| 2022 | $5.77 billion | 6,524,784 | 1,311,333 | $885 |
| 2021 | $5.23 billion | 6,458,283 | 1,258,010 | $809 |
| 2020 | $4.70 billion | 6,491,930 | 1,184,718 | $724 |
Source: CMS Medicare Part D spending by drug (data-year-2024, modified 2026-06-25), read November 7, 2026. CMS dataset page. All manufacturers combined; the figures are a drug-level aggregate of claims and say nothing about a formulary or coverage.
Medicaid use by state
CMS's State Drug Utilization Data records, for 2025, how many prescriptions each state's Medicaid program paid for under this drug's packages and what it reimbursed. The 10 states with the largest reimbursement are shown of 18 with data. Reimbursement is before the rebates manufacturers pay states, so it is not a net cost and not a price a patient pays.
| State | Medicaid-paid prescriptions | Medicaid reimbursed | Covers |
|---|---|---|---|
| CA | 245 | $230,829 | Fee-for-service only |
| KY | 429 | $206,013 | Fee-for-service only |
| OR | 256 | $146,490 | Fee-for-service only |
| HI | 96 | $120,961 | All record types |
| UT | 209 | $119,028 | Fee-for-service only |
| MN | 77 | $74,630 | Fee-for-service only |
| MI | 77 | $71,893 | Fee-for-service only |
| GA | 145 | $63,946 | Fee-for-service only |
| MD | 69 | $62,520 | Fee-for-service only |
| NV | 151 | $59,365 | All record types |
Where the publisher suppresses small managed-care cells, a state's figure covers fee-for-service claims only and understates use (14 state and package figures are marked that way here). A state missing from the table means its figures were suppressed or not reported, not zero use. 428 older-year figures are held and left out of the table.
Source: CMS State Drug Utilization Data (State Drug Utilization Data 2025, modified 2026-07-13T15:28:32Z), read November 7, 2026. CMS dataset page. State-reported data compiled by CMS; aggregate by state and package, no provider or patient data.
Where help paying exists
Offers the program pages state
- Manufacturer savings card
The J&J withMe Xarelto page states pay as little as $10 per fill for patients with commercial or private insurance, with a maximum annual program benefit of $3,975 and limits to savings per fill. No end date is stated.
Read November 7, 2026; quote matched against the saved page text.
Programs in our finder that list rivaroxaban. Each shows its income ceiling, when we read it and whether we checked it against the program's own document. Eligibility is decided by the program, not by us.
- Johnson & Johnson Patient Assistance Program manufacturer
Income at or below $46,950 for one person or $63,450 for two (J&J 2026 program limit, 300% of the 2025 poverty guideline)
Limit read October 19, 2026. - Bayer Patient Assistance Foundation manufacturer
Income at or below 300% of the poverty level
Figure not yet re-read on the program's own page. - Janssen CarePath Savings for Xarelto manufacturer
No income limit in our data
Figure not yet re-read on the program's own page.
Check where your income sits against each ceiling: open the assistance finder. See what has changed and when we last verified each program on the program status board.
Label changes
FDA actions on the applications behind Xarelto dated since November 11, 2025, leaving out manufacturing (CMC) changes. 2 changes in the window.
| Date | Class | Application | Submissions | FDA documents |
|---|---|---|---|---|
| March 24, 2026 | Labeling | NDA022406 | 45 | Label (PDF) posted March 26, 2026FDA letter posted March 27, 2026 |
| March 24, 2026 | Labeling | NDA215859 | 7 | Label (PDF) posted March 27, 2026FDA letter posted March 27, 2026 |
Source: FDA Drugs@FDA data file, read November 7, 2026. Dates are the FDA action dates; the documents are on FDA's own site. FDA data file. All recent changes across these drugs: label changes feed.
Clinical trials recruiting
ClinicalTrials.gov lists 67 interventional trials that name rivaroxaban and are recruiting, and 21 more not yet recruiting. By phase: Phase 4: 30, Not applicable: 16, Phase 3: 13, Early phase 1: 3, Phase 1: 2, PHASE2/PHASE3: 2, Phase 2: 1. The 10 most recently updated are below. A listing is not an offer of free drug and not medical advice. Whether a trial fits is decided by the study team and your own clinician.
| Trial | Title and conditions | Phase | Lead sponsor | Last updated | Countries |
|---|---|---|---|---|---|
| NCT07318610 | Reducing Adverse Vascular Outcomes With Factor XI Inhibition in Adult Participants With Peripheral Artery DiseasePeripheral Artery Disease (PAD) | Phase 3 | Regeneron Pharmaceuticals | November 5, 2026 | United States, United Kingdom |
| NCT05701917 | DEFIANCE: RCT of ClotTriever System Versus Anticoagulation In Deep Vein ThrombosisVenous Thromboembolism; Deep Venous Thrombosis; Post-Thrombotic Syndrome | Not applicable | Inari Medical | November 3, 2026 | United States, Austria, Finland and 3 more |
| NCT07907211 | Aspirin vs. Rivaroxaban for Thromboprophylaxis in Multiple MyelomaMultiple Myeloma; Venous Thromboembolism (VTE) | Phase 4 | Chen Lijuan | October 30, 2026 | China |
| NCT06978439 | Model-informed Dose Optimization for Rivaroxaban in Children With Giant Coronary Artery Aneurysm After Kawasaki DiseaseKawasaki Disease; Pilot Study; Coronary Artery Aneurysm | Phase 4 | Children's Hospital of Fudan University | October 22, 2026 | China |
| NCT06401616 | Can Patients With Atrial Fibrillation Safely Discontinue Anticoagulant Therapy After Cardiac Surgery? (ATLAAC)Atrial Fibrillation; Left Atrial Appendage Absent; Anticoagulant Adverse Reaction | Phase 4 | Odense University Hospital | October 21, 2026 | Denmark |
| NCT07869615 | Comparison of DOACs and LMWH for Thromboprophylaxis After Total Knee ArthroplastyTotal Knee Arthroplasty; Venous Thromboembolism | Not applicable | Military Hospital of Tunis | October 16, 2026 | Tunisia |
| NCT05775965 | HIP Fracture Oral thromboPROphylaxis (Hip PRO Pilot)Hip Fractures | Phase 2 | University of Calgary | October 9, 2026 | Canada |
| NCT04642430 | COmparison of Bleeding Risk Between Rivaroxaban and Apixaban in Patients With Atrial FibrillationAtrial Fibrillation | Phase 4 | Ottawa Hospital Research Institute | October 1, 2026 | Canada |
| NCT06571149 | Safety and Efficacy of Intravenous Thrombolysis in Patients With Ischemic Stroke and Direct Oral Anticoagulants IntakeIschemic Stroke | Phase 4 | Insel Gruppe AG, University Hospital Bern | September 30, 2026 | Austria, Belgium, Canada and 7 more |
| NCT06650501 | Dabigatran vs. Oral Anti-Xa Inhibitors in S. Aureus BacteremiaStaphylococcus Aureus Endocarditis; Staphylococcus Aureus Septicemia; Staphylococcus Aureus Bacteremia | Phase 4 | McGill University Health Centre/Research Institute of the McGill University Health Centre | September 24, 2026 | Canada |
Source: ClinicalTrials.gov, registry data processed November 6, 2026, summarized and trimmed by OmniRx. Search on ClinicalTrials.gov.
Questions
What is the Medicare negotiated price of Xarelto?
For a 30-day supply the price CMS published is $197, in force since January 1, 2026. CMS's file lists all 19 packages of Xarelto as deselected from the negotiation program, with the negotiated price ending December 31, 2026. After that date there is no negotiated price for them. The file does not say why. This is a price CMS agreed with the manufacturer for Medicare Part D, not what a person pays at the counter.
How does the negotiated price compare with what pharmacies pay?
Across the 19 packages where both CMS files give a price per unit, the median negotiated price is 35% of NADAC, the pharmacy acquisition benchmark (NADAC as of November 4, 2026). NADAC is a survey average, not a quote.
Is there help paying for Xarelto?
3 assistance programs list it in our finder. Eligibility depends on income, coverage and the program's current rules; each program's own page decides.
When could a generic version of Xarelto arrive?
For Xarelto, the FDA's Orange Book (edition September 2026) lists these latest patent or exclusivity expiry dates by application: NDA022406, August 17, 2034. Each date is an upper bound from listed patent and exclusivity dates, not a forecast of when a generic will launch. Basis: latest of all listed patent and exclusivity expiries in this Orange Book edition; an upper bound from listed dates only, not a forecast of launch (litigation, settlements, delisting, tentative approvals and 180-day status are not modelled).
Can I join a clinical trial for Xarelto?
ClinicalTrials.gov lists 67 recruiting interventional trials that name rivaroxaban (registry data processed November 6, 2026). A listing is not an offer of free drug and not medical advice. Whether a trial fits is decided by the study team and your own clinician.
How much does Medicare Part D spend on Xarelto?
CMS's Medicare Part D spending dataset reports gross spending on Xarelto of $6.23 billion in 2024, across 6,660,246 claims and 1,321,019 beneficiaries. CMS's dataset states spending is gross drug cost and does not reflect manufacturers' rebates or other price concessions. Spending is the total paid by Medicare, plans and beneficiaries for the drug's claims, not what a patient pays.
For developers: this drug as data
One call returns price, generic-entry upper bound, label history, recalls, trials, assistance, and where facts exist the FDA safety program (REMS), DEA schedule, orphan designations, safety notices and Medicaid use by state, each with receipts.
Example file: https://omnirx.org/api/v1/dossier/xarelto.json
The licence page sets out what a data licence covers, and the API page documents these files.
Evaluation files with receipts; contract may change; not clinical advice.
Sources and terms. CMS Medicare Drug Price Negotiation Program data file (read November 6, 2026; the CMS page states no licence or restriction); CMS NADAC from data.medicaid.gov under the labels in the OmniRx licence ledger; program details read from each program's own pages; CMS Medicare Part D spending by drug; FDA Drugs@FDA and Orange Book data files; ClinicalTrials.gov registry data. Figures are stored with their sources in the OmniRx library (edition 2026-11). Free to cite with attribution. Not medical, legal or financial advice. Report an error through the contact page. Licence the data.