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van den Heuvel JM, Hövels AM, Büller HR, et al. NOACs replace VKA as preferred oral anticoagulant among new patients: a drug utilization study in 560 pharmacies in The Netherlands. Thromb J. 2018;16:7doi: 10.1186/s12959-017-0156-y.
van den Heuvel, J. M., Hövels, A. M., Büller, H. R., Mantel-Teeuwisse, A. K., de Boer, A., & Maitland-van der Zee, A. H. (2018). NOACs replace VKA as preferred oral anticoagulant among new patients: a drug utilization study in 560 pharmacies in The Netherlands. Thrombosis journal, 167. https://doi.org/10.1186/s12959-017-0156-y
van den Heuvel, J M, et al. "NOACs replace VKA as preferred oral anticoagulant among new patients: a drug utilization study in 560 pharmacies in The Netherlands." Thrombosis journal vol. 16 (2018): 7. doi: https://doi.org/10.1186/s12959-017-0156-y
van den Heuvel JM, Hövels AM, Büller HR, Mantel-Teeuwisse AK, de Boer A, Maitland-van der Zee AH. NOACs replace VKA as preferred oral anticoagulant among new patients: a drug utilization study in 560 pharmacies in The Netherlands. Thromb J. 2018 Apr 18;16:7. doi: 10.1186/s12959-017-0156-y. eCollection 2018. PMID: 29692686; PMCID: PMC5905161.
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Thromb J. 2018 Apr 18;16:7. doi: 10.1186/s12959-017-0156-y. eCollection 2018.

NOACs replace VKA as preferred oral anticoagulant among new patients: a drug utilization study in 560 pharmacies in The Netherlands.

Thrombosis journal

J M van den Heuvel, A M Hövels, H R Büller, A K Mantel-Teeuwisse, A de Boer, A H Maitland-van der Zee

Affiliations

  1. 1Utrecht Institute for Pharmaceutical Sciences (UIPS), Division of Pharmacoepidemiology and Clinical Pharmacology, Utrecht University, Utrecht, The Netherlands.
  2. 2Department of Respiratory Medicine, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands.
  3. 3Department of Vascular Medicine, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands.

PMID: 29692686 PMCID: PMC5905161 DOI: 10.1186/s12959-017-0156-y

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.

Conflict of interest statement

For this study, data from the NControl database were obtained. Our dataset contains data of 544 pharmacies, spread across The Netherlands. Since 2011, the NControl database contains data related to ov

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