Yes, its a challenging problem. US is the only first world nation that pays for advanced drug development. Rest of the world just use fast copying generics providers (US also benefits from rest of the world investing in its stock market to fuel the domestic capitalism forces)

How to provide financial incentives for lengthly developments (safety testing) and practice more socialized healthcare is a huge challenge that hasn't been solved in US. What exist is stratified layers of healthcare and affordability. It would certainly be desirable to have the lower economic strata to have more affordability. But how to achieve this...

Problem is Medicaid is the only economic strata assist for the poorest (support by taxation rather than lower drug price/profit). Medicare is age based qualification and a huge number of older Americans. So Medicare is a huge market for healthcare companies and they are surely unwilling to give up so much of the profit source. Tricky issue on setting multiple price point strata is the lawyers has the potential to sue to drug companies to lock to the lowest price. So drug companies aren't going to self offer such solution. On some super expensive drugs (much pricier than Eliquis), drug company do offer support (free for qualified customer) but is likely based on US gov's poverty line definition so consumers above this strata is stuck with the higher cost.

Probably all that can be done is gov renegotiate Medicare price with healthcare companies when the drug/procedure reach high volume and huge profit level. Eliquis is probably getting close to this.