Warfarin Phased Out by Next Generation Agents?
March 5, 2014 7:54 AM Subscribe
posted by Mister_A (33 comments total)
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, for decades the standard of care for stroke prevention in patient with atrial fibrillation
, has met its match! Novel oral anticoagulants are the new
standard of care, with a favorable efficacy:safety profile
compared with warfarin. And what’s more, they don’t require regular monitoring
But not everyone is cheering. John Mandrola, MD, offers some perspective on the relative risk reductions
shown by the new drugs vs warfarin (free reg required). And a recent lawsuit alleges that Boehringer Ingelheim withheld unfavorable data on fatal bleeding,
the most feared adverse event for patients on chronic anticoagulation. FDA is also taking a second look at bleeding associated with BI's Pradaxa (dabigatran).
But in the end, it is the
payors who will decide the fate of these drugs, based on the total cost of medical care associated with their use. And right now, apixaban, rivaroxaban, and dabigatran are looking good, with an advantage in overall annual expenditure per patient driven largely by reduced costs associated with hemorrhagic stroke