Novel Oral Anticoagulants: Predicted vs actual analysis
Page last updated: 28 October 2016
Drug utilisation sub-committee (DUSC)
June 2016
Abstract
Purpose
To review the predicted versus actual use of the novel oral anticoagulants (NOACs), including apixaban, dabigatran and rivaroxaban, for prevention of stroke or systemic embolism in non-valvular atrial fibrillation (NVAF).
Date of listing on the Pharmaceutical Benefits Scheme (PBS)
- Rivaroxaban: 1 August 2013
- Apixaban: 1 September 2013
- Dabigatran: 1 September 2013
Data Source / methodology
Data were extracted from the DUSC and Department of Human Services (DHS) prescription databases from the earliest available data and continuing to December 2015. The DHS database was used for patient level analyses, including age, location, prescriber type, prior prescription, and time to refill.
Key Findings
- Based on the volume of prescriptions dispensed:
- NOACs contributed to a growth in the anticoagulant market since their
listing on the PBS for NVAF. - The use of warfarin has declined since the listing of NOACs on the PBS for NVAF.
- In calendar year 2015 for NOAC use in NVAF:
- There were 1,604,242 PBS-subsidised prescriptions supplied for 188,130 patients.
- For 72,484 patients, this was their first NOAC prescription.
- People starting anticoagulant therapy for the first time in 2014 and 2015 were more likely to commence on a NOAC than on warfarin.
- In 2015, the proportion of people initiating anticoagulant therapy with warfarin was greater in remote areas compared with metropolitan areas.
- In 2015, approximately 40% of prescriptions initiating anticoagulant therapy written by GPs were for warfarin compared to approximately 5% by cardiologists.
