Xarelto cost in 2026: TrumpRx, Medicare and the list price
Xarelto costs $197 for 30 tablets of 10, 15 or 20 mg through TrumpRx, the same amount Medicare negotiated for 2026; the list price is $612.
Xarelto (rivaroxaban), the once-daily anticoagulant from Johnson & Johnson, is one of the few drugs whose cash price and Medicare price meet: TrumpRx lists 30 tablets of 10, 15 or 20 mg at $197, exactly the $197 for 30 days that Medicare negotiated for 2026, while the list price shown on the same TrumpRx page is $612. A 90-tablet bottle is listed at three times that amount. Pharmacies pay about $586 for 30 tablets of 20 mg according to the NADAC survey of October 14, 2026. On Medicare, the standard Part D benefit puts a year of Xarelto at about $1,052 in 2026. The CMS file ends Xarelto’s negotiated price on December 31, 2026, with no 2027 price listed, so the calculator falls back to the list price for 2027.
The whole of 2026, by way of paying
- Paying cash (self-pay)$2,364
- Medicare Part D, covered use$1,052
- Medicaid, at a $4.00 copay$48
You would pay, Xarelto 20 mg
$197 / month
$2,364 in 2026
Self-pay price published by TrumpRx, the same through both.
Same dose, other ways to pay (per month)
- List price (wholesale acquisition cost)$612
- Self-pay: TrumpRx$197
- What pharmacies pay (NADAC)$586
- Medicare negotiated price, 2026$197
- Medicare Part D, your share (month avg., 2026)$88
TrumpRx and makers read on October 16, 2026 · NADAC file of October 14, 2026. Estimate only, not medical advice. How it is calculated
Prices read by Radif Partners · Editorial policy · Method and data
Prices by strength
| Tablet | TrumpRx, 30 tablets | List price, 30 tablets | Pharmacy cost (NADAC) | Medicare 2026 |
|---|---|---|---|---|
| 10 mg | $197 | $612 | $586 | $197 |
| 15 mg | $197 | $612 | $586 | $197 |
| 20 mg | $197 | $612 | $586 | $197 |
The 2.5 mg tablet, used twice a day with aspirin in vascular disease, is not on TrumpRx; its pharmacy cost is about half that of the other strengths per tablet, but twice-daily dosing brings the month back to a similar total.
TrumpRx or Medicare?
For someone on Medicare, the cash price is not a bargain worth taking: a self-pay purchase does not count toward the Part D deductible or the $2,100 cap, and the TrumpRx terms ask government beneficiaries not to seek reimbursement for it. The coinsurance on the negotiated price is a quarter of $197 once the deductible is met. For someone uninsured, or whose plan excludes Xarelto, $197 is a third of the list price.
What happens in 2027
CMS’s file lists a 2027 inflation-adjusted price for most 2026 drugs, but Xarelto’s 2027 line is dated to end before it starts, which the calculator reads as no negotiated price for 2027. Part D plans will then pay their own contracted price; the calculator uses the list price as the conservative basis and says so in the result.