Direct Oral Anticoagulants (DOACs)

Below are the database queries which are used to create this measure. These are run against a copy of the BSA prescribing data which we store in Google BigQuery. We're working on making our BigQuery tables publicly available at which point it will be possible to run and modify these queries yourself. But even where code and database queries are not directly useable by others we believe it is always preferable to make them public.

Description Prescribing of Direct Oral Anticoagulants (DOACs) as proportion of all DOACs and warfarin
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.
Tags Cardiovascular system, Standard, NICE
Implies cost savings No
History View change history on GitHub →

Numerator SQL

SELECT
     CAST(month AS DATE) AS month,
     practice AS practice_id,
     SUM(items) AS numerator
 FROM hscic.normalised_prescribing
 WHERE bnf_code IN ("0208020AAAAAAAA", "0208020AAAAABAB", "0208020AAAAACAC", "0208020AABBAAAA", "0208020AABBABAB", "0208020AABBACAC", "0208020X0AAAAAA", "0208020X0AAABAB", "0208020X0AAACAC", "0208020X0BBAAAA", "0208020X0BBABAB", "0208020X0BBACAC", "0208020Y0AAAAAA", "0208020Y0AAABAB", "0208020Y0AAACAC", "0208020Y0AAADAD", "0208020Y0AAAEAE", "0208020Y0AAAFAF", "0208020Y0BBAAAA", "0208020Y0BBABAB", "0208020Y0BBACAC", "0208020Y0BBADAD", "0208020Y0BBAEAE", "0208020Y0BBAFAF", "0208020Z0AAAAAA", "0208020Z0AAABAB", "0208020Z0BBAAAA", "0208020Z0BBABAB")
 GROUP BY month, practice_id

Denominator SQL

SELECT
     CAST(month AS DATE) AS month,
     practice AS practice_id,
     SUM(items) AS denominator
 FROM hscic.normalised_prescribing
 WHERE bnf_code IN ("0208020AAAAAAAA", "0208020AAAAABAB", "0208020AAAAACAC", "0208020AABBAAAA", "0208020AABBABAB", "0208020AABBACAC", "0208020V0AAAAAA", "0208020V0AAABAB", "0208020V0AAADAD", "0208020V0AAAIAI", "0208020V0AAAMAM", "0208020V0AAANAN", "0208020V0AAASAS", "0208020V0AABBBB", "0208020V0BBAAAA", "0208020V0BBABAB", "0208020V0BBACAD", "0208020V0BBAFAS", "0208020X0AAAAAA", "0208020X0AAABAB", "0208020X0AAACAC", "0208020X0BBAAAA", "0208020X0BBABAB", "0208020X0BBACAC", "0208020Y0AAAAAA", "0208020Y0AAABAB", "0208020Y0AAACAC", "0208020Y0AAADAD", "0208020Y0AAAEAE", "0208020Y0AAAFAF", "0208020Y0BBAAAA", "0208020Y0BBABAB", "0208020Y0BBACAC", "0208020Y0BBADAD", "0208020Y0BBAEAE", "0208020Y0BBAFAF", "0208020Z0AAAAAA", "0208020Z0AAABAB", "0208020Z0BBAAAA", "0208020Z0BBABAB")
 GROUP BY month, practice_id