NOACs replace VKA as preferred oral anticoagulant among new patients: a drug utilization study in 560 pharmacies in The Netherlands
Abstract Background In 2012, around 400.000 patients in the Netherlands were treated with Vitamin K Antagonists (VKA) for thromboembolic diseases. Since 2011, non-VKA oral anticoagulants (NOACs) are available. NOACs do not require frequent INR monitoring which benefits patients, but also imposes a r...
| Main Authors: | , , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2018-04-01
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| Series: | Thrombosis Journal |
| Online Access: | http://link.springer.com/article/10.1186/s12959-017-0156-y |
| _version_ | 1818443986271993856 |
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| author | J. M. van den Heuvel A. M. Hövels H. R. Büller A. K. Mantel-Teeuwisse A. de Boer A. H. Maitland-van der Zee |
| author_facet | J. M. van den Heuvel A. M. Hövels H. R. Büller A. K. Mantel-Teeuwisse A. de Boer A. H. Maitland-van der Zee |
| author_sort | J. M. van den Heuvel |
| collection | DOAJ |
| description | Abstract Background In 2012, around 400.000 patients in the Netherlands were treated with Vitamin K Antagonists (VKA) for thromboembolic diseases. Since 2011, non-VKA oral anticoagulants (NOACs) are available. NOACs do not require frequent INR monitoring which benefits patients, but also imposes a risk of reduced therapy adherence. The objective of this study is to describe uptake and patient adherence of NOACs in The Netherlands until October 2016. Methods Prescription data for 247.927 patients across 560 pharmacies were used to describe patient profiles, uptake of NOACs among new naive patients and switch between VKA and NOACs, and calculate therapy adherence as the Proportion of Days Covered (PDC). Results During the studied period the share of NOACs in oral anticoagulants has grown to 57% of prescriptions to new patients. More than 70% of new NOAC users were new naive patients and around 26% switched from VKA. The overall share of NOACs among starters is largest in the group of patients of 50-80 years. Calculated compliance rate for NOAC patients shows that 88% of all users are adherent with a PDC higher than 80%. Conclusions NOAC have overtaken VKA as the major treatment prescribed to new oral anticoagulant patients, and the number of starters on VKA is decreasing. Patients are generally adherent to NOACs during the implementation phase, the period that the medication is used. Fear for inadherence by itself does not need to be a reason for not prescribing NOACs instead of VKA. |
| first_indexed | 2024-12-14T19:08:45Z |
| format | Article |
| id | doaj.art-27958c4f5cb74c558309e1cd43ca9ab5 |
| institution | Directory Open Access Journal |
| issn | 1477-9560 |
| language | English |
| last_indexed | 2024-12-14T19:08:45Z |
| publishDate | 2018-04-01 |
| publisher | BMC |
| record_format | Article |
| series | Thrombosis Journal |
| spelling | doaj.art-27958c4f5cb74c558309e1cd43ca9ab52022-12-21T22:50:46ZengBMCThrombosis Journal1477-95602018-04-0116111010.1186/s12959-017-0156-yNOACs replace VKA as preferred oral anticoagulant among new patients: a drug utilization study in 560 pharmacies in The NetherlandsJ. M. van den Heuvel0A. M. Hövels1H. R. Büller2A. K. Mantel-Teeuwisse3A. de Boer4A. H. Maitland-van der Zee5Utrecht Institute for Pharmaceutical Sciences (UIPS), Division of Pharmacoepidemiology and Clinical Pharmacology, Utrecht UniversityUtrecht Institute for Pharmaceutical Sciences (UIPS), Division of Pharmacoepidemiology and Clinical Pharmacology, Utrecht UniversityDepartment of Vascular Medicine, Academic Medical Center, University of AmsterdamUtrecht Institute for Pharmaceutical Sciences (UIPS), Division of Pharmacoepidemiology and Clinical Pharmacology, Utrecht UniversityUtrecht Institute for Pharmaceutical Sciences (UIPS), Division of Pharmacoepidemiology and Clinical Pharmacology, Utrecht UniversityUtrecht Institute for Pharmaceutical Sciences (UIPS), Division of Pharmacoepidemiology and Clinical Pharmacology, Utrecht UniversityAbstract Background In 2012, around 400.000 patients in the Netherlands were treated with Vitamin K Antagonists (VKA) for thromboembolic diseases. Since 2011, non-VKA oral anticoagulants (NOACs) are available. NOACs do not require frequent INR monitoring which benefits patients, but also imposes a risk of reduced therapy adherence. The objective of this study is to describe uptake and patient adherence of NOACs in The Netherlands until October 2016. Methods Prescription data for 247.927 patients across 560 pharmacies were used to describe patient profiles, uptake of NOACs among new naive patients and switch between VKA and NOACs, and calculate therapy adherence as the Proportion of Days Covered (PDC). Results During the studied period the share of NOACs in oral anticoagulants has grown to 57% of prescriptions to new patients. More than 70% of new NOAC users were new naive patients and around 26% switched from VKA. The overall share of NOACs among starters is largest in the group of patients of 50-80 years. Calculated compliance rate for NOAC patients shows that 88% of all users are adherent with a PDC higher than 80%. Conclusions NOAC have overtaken VKA as the major treatment prescribed to new oral anticoagulant patients, and the number of starters on VKA is decreasing. Patients are generally adherent to NOACs during the implementation phase, the period that the medication is used. Fear for inadherence by itself does not need to be a reason for not prescribing NOACs instead of VKA.http://link.springer.com/article/10.1186/s12959-017-0156-y |
| spellingShingle | J. M. van den Heuvel A. M. Hövels H. R. Büller A. K. Mantel-Teeuwisse A. de Boer A. H. Maitland-van der Zee NOACs replace VKA as preferred oral anticoagulant among new patients: a drug utilization study in 560 pharmacies in The Netherlands Thrombosis Journal |
| title | NOACs replace VKA as preferred oral anticoagulant among new patients: a drug utilization study in 560 pharmacies in The Netherlands |
| title_full | NOACs replace VKA as preferred oral anticoagulant among new patients: a drug utilization study in 560 pharmacies in The Netherlands |
| title_fullStr | NOACs replace VKA as preferred oral anticoagulant among new patients: a drug utilization study in 560 pharmacies in The Netherlands |
| title_full_unstemmed | NOACs replace VKA as preferred oral anticoagulant among new patients: a drug utilization study in 560 pharmacies in The Netherlands |
| title_short | NOACs replace VKA as preferred oral anticoagulant among new patients: a drug utilization study in 560 pharmacies in The Netherlands |
| title_sort | noacs replace vka as preferred oral anticoagulant among new patients a drug utilization study in 560 pharmacies in the netherlands |
| url | http://link.springer.com/article/10.1186/s12959-017-0156-y |
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