XARELTO: what pharmacies pay, and what that tells you
XARELTO costs a pharmacy a median of $19.54 per unit. Its generic equivalent costs $0.6496, which makes the brand 30.1 times the price of the same molecule. That is what the pharmacy pays to acquire it. It is not your price: a dispensing fee and margin sit between this number and your receipt.
The substitution is worth real money here
XARELTO runs 30.1 times its generic equivalent on a drug that already costs a pharmacy $19.54 a unit. At that level the multiple is not an abstraction: switching to the same molecule is the single largest sum available on this prescription.
Where it sits against every other priced drug
Acquisition cost percentile, 3,234 priced products
This sits toward the expensive end of the corpus, dearer than roughly 86% of priced products, which is the range where coverage design starts to matter more than which pharmacy you walk into.
The brand and the generic, side by side
Acquisition cost per unit, CMS's own correspondence
$19.54 against $0.6496. The generic bar is drawn to scale, which is why it is barely visible at 30.1x. CMS publishes this correspondence per product, so it is a comparison of the same thing rather than a match on names.
The other forms of XARELTO
CMS prices 2 distinct XARELTO products. They are not interchangeable and their costs are not comparable to each other, which is exactly why a single headline price for a drug name is usually meaningless.
The Sold as column is usually the reason two rows differ: an over-the-counter product and a prescription-strength one carry the same drug name and are priced as different products entirely. Unit matters as much: a price per tablet and a price per millilitre are not the same measurement.
| Product | Unit | Class | Sold as | Per unit | Listings |
|---|---|---|---|---|---|
| XARELTO (shown above) | EA | Brand | Rx | $19.54 | 17 |
| XARELTO | ML | Brand | Rx | $3.77 | 1 |
What the spread tells you about shopping around
Between the cheapest tenth of listings and the dearest tenth, XARELTO varies by 2.0 times. That is a tight band. That is less ordinary at this cost level, where products more often vary between suppliers. Pharmacies are buying it at close to the same price, so a difference in what you are charged is a difference in fees and margin rather than in the drug.
The drug sets the floor. The route decides the rest.
XARELTO costs a pharmacy $19.54 per unit, which is the floor under what you pay. A dispensing fee and a margin sit on top, and both are set by where you fill it and under what programme. These are the routes worth checking, and what each one is actually for.
- Cost Plus Drugs sells at a stated markup over its own acquisition cost, so the pharmacy margin is visible rather than inferred. What we found
- Honeybee Health a mail-order pharmacy that posts cash prices publicly, which makes it a useful sanity check on any card quote. What we found
- Amazon Pharmacy mail order, so it competes on the dispensing fee rather than on the drug. What we found
- GoodRx a discount card negotiated per pharmacy, so the same drug can differ between two shops on one street. What we found
- SingleCare the same mechanism as a rival card, and worth checking against it rather than instead of it. What we found
- RxSaver another card on the same model; cards are cheap to compare and routinely disagree with each other. What we found
- WellRx a fourth card, listed because checking one card and stopping is the most common way to overpay. What we found
- Blink Health prepay-then-collect, which prices the drug before you reach the counter. What we found
- Costco membership pharmacy pricing, which US federal law makes available without a membership. What we found
- Walmart a flat-price generic list, which beats a card on some drugs and loses badly on others. What we found
- CVS and Walgreens, the default retail route, and usually the one every other option is measured against. What we found
We do not quote a per-pharmacy price for XARELTO, because that varies by pharmacy, by ZIP code and by week, and we have not measured it for this drug. What is measured here is the acquisition cost above, from CMS NADAC. The order of these routes is editorial and fixed; it is not for sale, and no placement here implies a medical recommendation.
There is an assistance programme covering this
J&J Patient Assistance Foundation (JJPAF). Estimated saving: Free medication for qualifying patients (savings of $1,000 to $15,000+ per month).
What this page is, and is not
Every figure here is CMS NADAC, the federal survey of what retail pharmacies pay to acquire a drug. It is public-domain federal data and it is the cleanest available floor. It excludes your dispensing fee, your pharmacy's margin, your insurance design and any discount-card pricing, all of which sit between this number and what you hand over. Nothing here is medical advice.
Source: CMS NADAC (National Average Drug Acquisition Cost), Centers for Medicare & Medicaid Services, dataset generated 2026-10-13. See how XARELTO compares across 385 brand and generic pairs, or look up another drug in our price tools.