Andexanet alfa for reversing anticoagulation from apixaban or rivaroxaban

2.1 Andexanet alfa (Ondexxya, AstraZeneca) has a conditional marketing authorisation for 'adult patients treated with a direct factor Xa (FXa) inhibitor (apixaban or rivaroxaban) when reversal of anticoagulation is needed due to life-threatening or uncontrolled bleeding'.

2.2 The dosage schedule is available in the summary of product characteristics.

2.3 The list price for andexanet alfa is £11,100 per 4-vial pack of 200 mg of powder for solution for infusion (excluding VAT, BNF online accessed March 2021). The average cost of a course of treatment at list price is £15,000 per patient.

2.4 The company has a commercial arrangement. This makes andexanet alfa available to the NHS with a discount. The size of the discount is commercial in confidence. It is the company's responsibility to let relevant NHS organisations know details of the discount.