Department of Pharmacology & Therapeutics, Trinity College Dublin.
Health Services Executive (HSE) Medicines Management Programme.
Ir Med J. 2020 May 7;113(5):71.
Aims This study determined the impact of the direct oral anticoagulants (DOACs) on the utilisation and expenditure on oral anticoagulants (OACs) in the Irish Community healthcare setting. We also investigated aspects of DOAC prescribing. Methods Using anonymised prescription data from the HSE pharmacy claims database we investigated anticoagulant prescribing over the study period (1/1/2014 - 31/12/2018). Results Some 74,748 patients were being treated with OACs by the year end 2018 an increase of 30,319 over 5 years. Warfarin prescribing fell from 32,751 patients in 2014 to 16,166 by the year end 2018. Apixaban is the most frequently prescribed OAC and annual expenditure on DOACs now exceeds € 51 million. Patients treated with DOACs are older than participants in the pivotal clinical trials and are frequently co-administered interacting drugs. Conclusion The introduction of DOACs has resulted in an overall increase in anticoagulant prescribing, a significant reduction in warfarin usage and a large increase in expenditure.
本研究旨在确定直接口服抗凝剂（DOACs）对爱尔兰社区医疗保健环境中口服抗凝剂（OACs）的使用和支出的影响。我们还调查了 DOAC 处方的一些方面。
我们使用 HSE 药房索赔数据库中的匿名处方数据，调查了研究期间（2014 年 1 月 1 日至 2018 年 12 月 31 日）的抗凝剂处方情况。
截至 2018 年底，共有 74748 名患者正在接受 OAC 治疗，比 5 年前增加了 30319 名。华法林的处方量从 2014 年的 32751 名患者下降到 2018 年底的 16166 名。阿哌沙班是最常开的 OAC，DOAC 的年支出现在已超过 5100 万欧元。使用 DOAC 的患者比关键临床试验中的参与者年龄更大，并且经常同时服用相互作用的药物。
DOAC 的引入导致抗凝剂的总体使用增加，华法林的使用显著减少，支出大幅增加。
