Trends and variation in andexanet alfa for the reversal of direct oral anticoagulants in NHS Trusts in England
Fisher, L.; Buka, R.; Byrne, R.; Black, S.; Curtis, H. J.; Wood, C.; Brown, A.; Bacon, S.; Croker, R.; Goldacre, B.; MacKenna, B.; Speed, V.
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Andexanet alfa was recommended by the National Institute for Health and Clinical Excellence (NICE) as an option in the management of major gastrointestinal bleeding in patients taking apixaban or rivaroxaban in May 2021. To assess the uptake of andexanet alfa, we analysed pharmacy stock control data from NHS Trusts in England using the openly available Secondary Care Medicines Dataset. Between May 2021 and July 2024, 14,092 vials of andexanet alfa were issued in NHS Trusts in England. There was wide variation in uptake across NHS Trusts, which likely reflects variation in local protocols. This study is the first analysis of adoption of a new treatment using the OpenPrescribing Hospitals platform, which is expected to provide a generalisable framework for similar analyses in the future.
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