Why it matters: Direct Oral Anticoagulants (DOACs - also known as Novel Oral Anticoagulants - NOACs) are recommended in various NICE guidance, including for the prevention of stroke in patients with Atrial Fibrillation (AF). Before the introduction of DOACs warfarin was the mainstay of anticoagulant treatment. DOACs cost more than warfarin. Nationally oral anticoagulant costs have increased 9-fold in three years from 2013, an increase of approximately £200 million per year. DOACs do not requre INR testing, unlike warfarin. There has been considerable debate about the place of DOACs in AF stroke prevention given the positive NICE recommendation and the cost impact to the NHS, and consequently there has been variable uptake across the country.
Description: Prescribing of Direct Oral Anticoagulants (DOACs) as proportion of all DOACs and warfarin
CCGs are ordered by mean percentile over the past six months. Each chart shows the results for the individual CCG, plus deciles across all CCGs in the NHS in England.