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Novel Anticoagulants Rapidly Adopted Into Clinical Practice

In six months after initiation, combined patient, insurer spending higher for novel anticoagulants

THURSDAY, Jan. 8, 2015 (HealthDay News) -- Novel anticoagulants have been rapidly adopted into clinical practice, and their use is associated with increased health care costs, according to a study published in the November issue of The American Journal of Medicine.

Using medical and prescription claims data from a large insurer, Nihar R. Desai, M.D., M.P.H., from Brigham and Women's Hospital and Harvard Medical School in Boston, and colleagues identified patients with nonvalvular atrial fibrillation who were prescribed an oral anticoagulant from 2010 to 2013. The authors examined trends in utilization over time and how the use of novel anticoagulants has impacted health spending for patients and insurers.

During the study period, the researchers identified 6,893 patients with atrial fibrillation who initiated an oral anticoagulant. Novel anticoagulants accounted for 62 percent of new prescriptions and 98 percent of anticoagulant-linked drug costs by the end of the study period. The odds of receiving a novel anticoagulant were significantly lower in association with female sex, lower household income, and higher CHADS2, CHA2DS2-VASC, and HAS-BLED scores (all P < 0.001). For patients initiating a novel anticoagulant, the average combined patient and insurer anticoagulant spending was more than $900 higher in the first six months after initiation.

"This study demonstrates rapid adoption of novel anticoagulants into clinical practice, particularly among patients with lower CHADS2 and HAS-BLED scores, and high health care cost consequences," the authors write.

The study was funded by an unrestricted grant from CVS Caremark; several authors are employed by CVS Caremark.

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