Eliquis and the New Pricing Landscape: How TrumpRX and Medicaid Deals Are Reshaping BMS' Future

For years, Bristol Myers Squibb (BMS) has relied on blockbuster drugs like Eliquis to drive growth. Now, a wave of policy shifts and corporate agreements is reshaping how this critical anticoagulant will be priced, accessed, and valued in the U.S. market. These developments, coming as the drug nears its patent expiration, have sparked questions for investors about the company's future. The short version: BMS is adapting to a new cost-conscious environment with creative deals that promise to keep Eliquis central to its portfolio — for now.

A New Era for Eliquis Pricing

At the heart of the story is a major agreement between BMS and the U.S. government. Starting January 1, 2026, Eliquis will be offered for free to the Medicaid program — a move designed to improve access while also shielding the drug from the full impact of generic competition for several more years. This agreement isn't just about price; it also includes a donation of more than seven tons of the active ingredient apixaban to the Strategic Active Ingredient Reserve, ensuring the U.S. maintains a supply in times of need.

The timing couldn't be better for BMS. The Inflation Reduction Act has already begun reshaping Medicare pricing, and in 2026, Medicare enrollees will pay roughly 50% less for Eliquis and other drugs. These lower prices aren't a threat yet — at least not in the near term — because BMS has taken steps to secure its position while also complying with new federal mandates.

Strategic Moves in a Changing Landscape

These moves come as BMS faces a looming patent cliff for Eliquis. Generics are expected to enter the U.S. market in 2028, and the company has responded with strategic acquisitions and a renewed focus on high-growth products like Reblozyl and Breyanzi. In Q3 2025, BMS reported $12.2 billion in revenue, showing its ability to maintain performance despite these challenges.

Meanwhile, the TrumpRX initiative — still in the early stages of rollout — is adding another layer of complexity. The platform, which will launch in January, will allow companies like BMS to sell medicines directly to patients at lower prices. Eliquis is among the drugs that will benefit from this new channel, with cash-paying patients seeing significant discounts. While TrumpRX isn't yet in full effect, it's already shaping how companies like BMS are approaching pricing and access.

What This Means for Investors

From an investor's perspective, the key takeaway is that BMS is taking proactive steps to manage the risks associated with patent expiration and regulatory pressure. The Medicaid and Medicare pricing deals provide near-term stability, while strategic investments are building long-term resilience. That said, the market isn't blind to the risks. In Q3, BMS' stock price showed volatility alongside broader industry concerns about drug pricing and competition.

Still, BMS remains in a strong position. With a 4.6% dividend yield and a payout ratio of just 22%, the company has room to continue rewarding shareholders while reinvesting in its pipeline. The focus on oncology and immunology is also a structural tailwind, given the growing demand for treatments in these areas.

Looking Ahead

The future for Eliquis and BMS hinges on a few key factors: the pace of generic entry, the success of new product launches, and how well the company adapts to the TrumpRX model. The Medicaid and Medicare agreements give BMS a few more years to maximize revenue while also complying with government cost controls. For now, the company's strategy appears to be working — but investors will be watching closely for any signs of strain as the 2028 patent expiration nears.

In the end, Eliquis is more than a drug. It's a symbol of how the pharmaceutical industry is evolving in the face of pricing pressure and policy changes. Whether BMS can keep Eliquis in the spotlight will depend on how well it balances innovation, pricing, and patient access — a challenge that will define the company's next chapter.