Current Prescribing Trends for Atrial Fibrillation Anticoagulation in Australia

Introduction: Management of stroke risk in atrial fibrillation has changed over the last few years with the introduction of novel oral anticoagulants (NOACs) such as Apixaban, Rivaroxaban and Dabigatran. These agents are being increasingly prescribed secondary to the ease of use compared to warfarin which requires regular and ongoing INR monitoring. Methods: In this study we reviewed the available statistical data collected by the PBS (September 2013 to August 2015) for the number of scripts filled under the PBS/RPBS using the item codes specific for atrial fibrillation for each NOAC. Results: There has been a steady increase in use of combined novel anticoagulation used over a comparable time period. From September 2013 to August 2015 there has been an increase of NOAC use by over 5000% from 1821 to 97246 scripts combined. For the same months warfarin scripts actually decreased by 9.8% from 196,696 to 177,327. Since PBS listing in 2015; the percentage of the total oral anticoagulant prescriptions were 35% NOACs and 65% per cent warfarin. Conclusion: There is a clear trend of increasing use of novel anticoagulants compared to warfarin which has shown a corresponding decreasing trend over the same time period.