Doctors Paid $20 Million to Promote Xarelto and Other Blood Thinners

Thursday, January 15, 2015

With the market for newer anticoagulants growing to several billion dollars per year, it’s no surprise the leading competitors would spend a healthy chunk of change on advertising. Anyone with a TV has likely seen countless ads for Xarelto, Eliquis and Pradaxa.

What is somewhat unsettling, however, is that the manufacturers of these drugs also funnel millions of promotional dollars to doctors. Almost $20 million in just the past half year, to be exact.

The news came last week as industry watchdog ProPublica unveiled its latest analysis of Sunshine Act data from the last 5 months of 2013.

The drug companies Bayer and Johnson & Johnson, who make Xarelto; Pfizer and Bristol-Meyers, who make Eliquis; and Boehringer Ingelheim, who make Pradaxa, claim the money is being spent on doctor speaking engagements to better educate physicians on how to safely use their products.

However, insiders say the sponsored speakers are key to filling promotional gaps and getting the ear of doctors who will decide which product to prescribe. All of which is done so behind the backs of patients.

The newer blood thinners hit the market starting in 2010 with Pradaxa, then Xarelto in 2011 and Eliquis in 2012. Each promises it is safer and easier to use than the drug doctors relied on for over 50 years – warfarin.

The danger is internal bleeding. Every blood thinner has the risk of causing it. The question is - how bad is the risk, can doctors treat it and were patients made aware of it?

Some studies show the new anticoagulants may reduce some types of bleeding, and don’t require dietary changes or regular blood tests for dosage. However, they may also be more likely to cause other internal bleeding events and don’t have an emergency antidote doctors can use when it happens.

Eliquis led the way with doctor payments of around $8 million to close out 2013. That made it second among all drugs on the market for doctor spending. Xarelto makers paid almost $7 million to doctors, and Pradaxa shelled out $4.43 million.

While researchers are quickly trying to develop antidotes for major bleeding events caused by Xarelto, Eliquis or Pradaxa, many doctors are still skeptical about prescribing them. And, thousands of patients have filed lawsuits or FDA reports about Xarelto and Pradaxa bleeding.

Last year, Pradaxa maker BI had to pay $650 million to escape around 4,000 bleeding injury and death lawsuits. This year, Xarelto may face as many or more, as cases have now been combined in a distinct federal court.

Check back with DrugNews for more on these fast-growing drugs, or call us if you’d like to be connected with a lawyer to answer any questions.



Ornstein, C. Vying for Market Share, Companies Heavily Promote ‘Me Too’ Drugs. ProPublica. (January 7, 2015). Retrieved from

Staton, T. How Much for Docs Speaking on Eliquis, Xarelto and Pradaxa? $20M and Counting. FiercePharma. (January 8, 2015). Retrieved from


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