Proportion of Direct Acting Oral Anticoagulants (DOACs) not prescribed as edoxaban or generic apixaban by practices in NHS PORTSMOUTH
Why it matters: In January 2024 the NHS in England released updated commissioning regulations for DOACs, which state:
For patients commencing treatment for Atrial Fibrillation (AF): subject to the criteria specified in the relevant NICE technology appraisal guidance, clinicians should use the best value DOAC that is clinically appropriate for the patient.
Table 1 provides the available DOACs ranked from highest to lowest best value according to the November 2023 Drug Tariff and confidential framework prices. If the highest ranked best value DOAC (generic apixaban) is contraindicated or not clinically appropriate for the specific patient then, subject to the criteria specified in the relevant NICE technology appraisal guidance, clinicians should then consider the next highest ranked DOAC (edoxaban) and so on until an appropriate treatment is identified.
| Overall rank | DOAC | Notes |
|---|---|---|
| 1 (Best value) | generic apixaban | Best value twice a day treatment |
| 2 | Edoxaban (Lixiana®) | Best value once a day treatment |
| 3 | Rivaroxaban (Xarelto®) | |
| 4 | Dabigatran (Pradaxa®) | |
| 5 | Eliquis® (branded apixaban) |
The NHS England National Medicines Optimisation Opportunities for 2023/24 identify using best value direct-acting oral anticoagulants as an area for improvement.
Please note: OpenPrescribing.net measures have a consistent way of visualising measures, where 'lower is better' and therefore in this case we show the proportion of DOACs which are NOT prescribed as edoxaban or generic apixaban.
Description: Percentage DOACs items not prescribed as edoxaban or generic apixaban
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Tagged as: Cardiovascular system, Standard, Cost Saving, National medicines optimisation opportunities (or browse all measures for this Sub-ICB Location)
Practices are ordered by mean percentile over the past six months, with the worst-performing at the top. Each chart shows the results for the individual practice, plus deciles across all practices in the NHS in England.
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