This year, sales of Bristol Myers Squibb’s (BMS) and Pfizer’s drug Eliquis (apixaban) are projected to decline by 15.2% due to the loss of its European market exclusivity on 19 May 2026. The BMS-Pfizer alliance has dominated the anticoagulant drug market, earning approximately $82.6bn in revenue since 2011, according to GlobalData’s Sales and Forecast Database. However, with the expiry date fast approaching, the loss of Eliquis’ exclusivity will inevitably mark the beginning
of a major patent cliff.

Eliquis first entered the European market in May 2011, following MHRA approvals for various thromboembolic diseases, revolutionising thromboprophylaxis. The second-generation direct oral anticoagulant (DOAC) Eliquis prevents clot
formation through the direct and reversible inhibition of free and clot-bound factor Xa, a key enzyme in the clotting cascade. Unlike traditional anticoagulants, DOACs have significantly higher safety profiles, with the reduced need for monitoring, setting them apart from traditional anticoagulants such as warfarin. Such factors have led to its takeover as a first-line treatment or prophylaxis of various cardiovascular diseases, including pulmonary embolism and non-valvular atrial fibrillation.

Figure 1 (below) highlights Eliquis’ global sales growth, with a compound annual growth rate of 108.3% since its emergence in the European market. However, this incline is forecast to peak at just under $14.2bn in 2025, with a predicted 15.2% drop following European expiry and the expected entry of generics into the market. Overall, Eliquis’ sales are predicted to decline by 92.3% by 2030 in comparison to 2025. BMS and Pfizer have made attempts to extend Eliquis’ market exclusivity, which was initially set to expire in September 2022, via a supplementary protection certificate (SPC) filing. This extension has allowed for the generation of approximately $29.5bn so far in additional revenue, effectively delaying the impending patent cliff.

Figure 1: Eliquis analyst consensus sales and forecast (2015 to 2031)

With US patent expiry expected in 2028, BMS and Pfizer are attempting to retain US market share through their direct-topatient Eliquis option, which they announced in July 2025. This program will provide underinsured, uninsured, or self-pay
American patients a reduction of over 40% for their prescriptions. The program, which came into effect in September 2025, will aim to mitigate incoming competition and expand Eliquis’ market access by targeting cash-paying patients, who constitute up to 10% of the patient population. Time will tell what real impacts this will have on the market, and if attempts to decelerate declining sales will be successful.

19 May will mark the start of a major transformation to the European anticoagulation market. With the pending entrance of generics, we can only expect a rapid decline in Eliquis’ reigning sales. BMS and Pfizer may be able to soften the blow to their US market shares in the next two years, but will that be enough to curb the forecast drop in sales following the eventual loss of global exclusivity?