NHS saves millions on highly effective stroke drugs

Researchers from the Health Economics Unit and University of Leeds analysed the cost of prescribing direct oral anticoagulants (DOACs) to treat stroke patients in 2011-2014 and compared it with that in 2014-2017.

In the paper, published in Heart Journal, the researchers found that prescribing costs for DOACs to treat atrial fibrillation (AF) had risen £149 per year per patient (£733 million) but subsiquently fell by £289 (25%) due to their effectiveness in preventing strokes and reducing care costs.

Chris Gale, Professor of Cardiovascular Medicine, Consultant Cardiologist and co-author from the University of Leeds, said:

“Despite an increase in the use of DOACs for the prevention of stroke in people with AF, there remain notable gaps in the use of these drugs. This is important because these drugs reduced the risk of stroke.

“But DOACS are expensive, and their costs may be a barrier to their use in the NHS.

“We found that the total costs of oral anticoagulant between 2014 and 2017 was huge, but because they were associated with a reduction in stroke, there was a per-patient saving to the NHS.”

Andi Orlowski from the Health Economics Unit, an NHS analytics organisation, said:

“Across the study period there was nearly a doubling of the number of people being treated with oral anticoagulant, primarily driven by DOAC. This amazing increase in the numbers receiving treatment reduced stroke by 11% and understandably came with a significant budget impact. We must remember that all oral nticoagulants are cost effective and the cost per person treated, when taking in to account the costs associated with managing stroke, reduced by nearly £290 a head.

“There is still work to do to ensure everyone at risk of an AF related stroke who wants an OAC receives one but this study shows the huge improvement the NHS has made in the last few years.”

Patients with AF are five times more likely to suffer a stroke. The condition is believed to cause around a third of ischaemic stroke and to increase the severity.

The cost of prescribing DOACs is estimated at 5% of the overall drug budget in England.