Clinical and budget impacts of changes in oral anticoagulation prescribing for atrial fibrillation
English study found that despite nearly one million additional DOAC prescriptions and substantial associated spending in the latter part of this study, the decline in AF-related stroke (fell by 11.3%) led to incremental savings (£289 per-patient) at the national level.
Source:
Heart
SPS commentary:
An editorial notes that as this is an epidemiological study, coincidence does not mean causality. Other factors including improved management of vascular risk factors over the study time frame definitely played a role in reducing the rate of strokes. Furthermore, several assumptions have been made in the model and the costs were only lower after adjustment for atrial fibrillation prevalence, which probably mainly increased because of longer monitoring. It concludes nevertheless that this study provides reassuring data for all stakeholders in a national healthcare system and a new, additional and significant argument why DOACs should be prescribed to patients with a clear indication.