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Trends in Oral Anticoagulant Use and Individual Expenditures Across the United States from 2014 to 2020.
Alkhezi, Omar S; Buckley, Leo F; Fanikos, John.
Afiliación
  • Alkhezi OS; Department of Pharmacy Practice, College of Pharmacy, Qassim University, Qassim, Saudi Arabia. o.alkhezi@qu.edu.sa.
  • Buckley LF; Department of Pharmacy Services, Brigham and Women's Hospital, Boston, MA, USA. o.alkhezi@qu.edu.sa.
  • Fanikos J; Department of Pharmacy Services, Brigham and Women's Hospital, Boston, MA, USA.
Am J Cardiovasc Drugs ; 24(3): 433-444, 2024 May.
Article en En | MEDLINE | ID: mdl-38583107
ABSTRACT

BACKGROUND:

Landmark clinical trials have expended the indications for the direct oral anticoagulants (DOACs), but contemporary data on usage and expenditure patterns are lacking.

OBJECTIVE:

This study aimed to assess annual trends in oral anticoagulant (OAC) utilization and expenditure across the United States (US) from 2014 to 2020.

METHODS:

We utilized the Medical Expenditure Panel Survey (MEPS) to study the trends of use and expenditures of warfarin, dabigatran, rivaroxaban, apixaban, and edoxaban between 2014 and 2020 in the US. Survey respondents reported OAC use within the past year, which was verified against pharmacy records. Payment information was obtained from the respondent's pharmacy and was categorized as third-party or self/out-of-pocket. Potential indications and medical conditions of interest for OAC therapy were identified from respondent-reported medical conditions. We estimated the national number of OAC users and total expenditures across age, sex, race, ethnicity, insurance, and medical condition subgroups. Trends of OAC users' characteristics, expenditure, and number of prescriptions were evaluated using the Mann-Kendall test for trends.

RESULTS:

Between 2014 and 2020, the number of warfarin users decreased from 3.8 million (70% of all OAC users) to 2.2 million (p = 0.007) [29% of all OAC users], while the number of DOAC users increased from 1.6 million (30% of all OAC users) to 5.4 million (p = 0.003) [70% of all OAC users]. The total expenditure of OACs in the US increased from $3.4 billion in 2014 to $17.8 billion in 2020 (p = 0.003), which was driven by the increase in DOAC expenditures (p = 0.003).

CONCLUSIONS:

DOACs have replaced warfarin as the preferred OAC in the US. The increased costs associated with DOAC use may decline when generic formulations are approved.
Asunto(s)

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Gastos en Salud / Anticoagulantes Límite: Adolescent / Adult / Aged / Aged80 / Female / Humans / Male / Middle aged País/Región como asunto: America do norte Idioma: En Revista: Am J Cardiovasc Drugs Asunto de la revista: ANGIOLOGIA / CARDIOLOGIA / TERAPIA POR MEDICAMENTOS Año: 2024 Tipo del documento: Article País de afiliación: Arabia Saudita Pais de publicación: Nueva Zelanda

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Gastos en Salud / Anticoagulantes Límite: Adolescent / Adult / Aged / Aged80 / Female / Humans / Male / Middle aged País/Región como asunto: America do norte Idioma: En Revista: Am J Cardiovasc Drugs Asunto de la revista: ANGIOLOGIA / CARDIOLOGIA / TERAPIA POR MEDICAMENTOS Año: 2024 Tipo del documento: Article País de afiliación: Arabia Saudita Pais de publicación: Nueva Zelanda