Featured Research

from universities, journals, and other organizations

Weighing up blood-thinners: Is warfarin always the best choice?

Date:
October 17, 2013
Source:
Springer Science+Business Media
Summary:
Patients who are responding below par to the anticoagulant drug warfarin have several options. They can undergo even more blood tests to monitor their response to the different dosages of this medication which is prescribed to prevent strokes, or they could start using one of the newer, yet more expensive, anticoagulants on the market. In the long run, the latter option could actually be more cost-effective and improve a patient's quality of life.

Patients who are responding below par to the anticoagulant drug warfarin have several options. They can undergo even more blood tests to monitor their response to the different dosages of this medication which is prescribed to prevent strokes, or they could start using one of the newer, yet more expensive, anticoagulants on the market. In the long run, says Joyce You of the Chinese University of Hong Kong in China, the latter option could actually be more cost-effective and improve a patient's quality of life. Her studyΉ appears in the Journal of General Internal Medicine², published by Springer. It is the first of its kind to comprehensively consider all important factors to measure the relative value-for-money of various oral anticoagulants currently on offer to patients and doctors.

The effectiveness of warfarin is influenced by the intake of Vitamin K and the impact of other medication. Incorrect dosages can, for instance, lead to excessive bleeding. Therefore health professionals consistently need to do blood tests to monitor its effectiveness.

According to previous studies, new oral anticoagulants such as dabigatran, rivaroxaban and apixabanare are as effective as warfarin in preventing strokes, and similarly all can cause bleeding in patients if not used correctly.. Warfarin, which has been on the market for decades, is still the number one anticoagulant used in the US and the UK, while the newer drugs are considered to be more expensive. Because they have a shorter half-life than warfarin, they lose their pharmacological effectiveness much sooner, and also need to be taken more regularly than warfarin.

To provide a definitive word on which is the most cost-effective in the long run within the broader medical care system, You compared the life-long economic and treatment outcomes of warfarin against the new generation medications. She ran a randomized statistical outcome analysis of a hypothetical group of 65-year-old people suffering from atrial fibrillation (a heart rhythm disorder), and also included additional information from previous clinical trials.

Dr. You specifically measured if the price tag of a specific treatment was worthwhile and if it influenced a patient's general quality of life, in the sense that the person could undergo fewer cumbersome blood tests or monitoring sessions to ensure that the treatment adequately prevented strokes. Generally, warfarin treatment is regarded as successful if a patient is within the needed therapeutic range for 75 percent or more of the time. A percentage less than 60 percent is sub-optimal, and generally needs more monitoring and intervention from practitioners.

Dr. You found that, generally, the use of warfarin was most cost-effective when patients were within the successful therapeutic range for more than 70 percent of the time. She found, however, that in patients where this range dropped below 60 percent, the more expensive new drugs were more cost-effective in the long run. Clinicians have the option of intensifying the management of warfarin therapy (including more frequent blood tests and management by specialists) until a 70 percent therapeutic range is reached, but this has added financial implications.

"The acceptance of the new oral anticoagulants as a more cost-effective option than warfarin therapy is highly dependent on the level of anticoagulation control achieved by warfarin therapy, cost for anticoagulation service to manage patients on warfarin, and drug cost of the new oral anticoagulants," You concluded.


Story Source:

The above story is based on materials provided by Springer Science+Business Media. Note: Materials may be edited for content and length.


Journal Reference:

  1. Joyce H. S. You. Novel Oral Anticoagulants Versus Warfarin Therapy at Various Levels of Anticoagulation Control in Atrial Fibrillation—A Cost-Effectiveness Analysis. Journal of General Internal Medicine, 2013; DOI: 10.1007/s11606-013-2639-2

Cite This Page:

Springer Science+Business Media. "Weighing up blood-thinners: Is warfarin always the best choice?." ScienceDaily. ScienceDaily, 17 October 2013. <www.sciencedaily.com/releases/2013/10/131017111239.htm>.
Springer Science+Business Media. (2013, October 17). Weighing up blood-thinners: Is warfarin always the best choice?. ScienceDaily. Retrieved July 24, 2014 from www.sciencedaily.com/releases/2013/10/131017111239.htm
Springer Science+Business Media. "Weighing up blood-thinners: Is warfarin always the best choice?." ScienceDaily. www.sciencedaily.com/releases/2013/10/131017111239.htm (accessed July 24, 2014).

Share This




More Health & Medicine News

Thursday, July 24, 2014

Featured Research

from universities, journals, and other organizations


Featured Videos

from AP, Reuters, AFP, and other news services

New Painkiller Designed To Discourage Abuse: Will It Work?

New Painkiller Designed To Discourage Abuse: Will It Work?

Newsy (July 24, 2014) — The FDA approved Targiniq ER on Wednesday, a painkiller designed to keep users from abusing it. Like any new medication, however, it has doubters. Video provided by Newsy
Powered by NewsLook.com
Doctor At Forefront Of Fighting Ebola Outbreak Gets Ebola

Doctor At Forefront Of Fighting Ebola Outbreak Gets Ebola

Newsy (July 24, 2014) — Sheik Umar Khan has treated many of the people infected in the Ebola outbreak, and now he's become one of them. Video provided by Newsy
Powered by NewsLook.com
Condemned Man's US Execution Takes Nearly Two Hours

Condemned Man's US Execution Takes Nearly Two Hours

AFP (July 24, 2014) — America's death penalty debate raged Thursday after it took nearly two hours for Arizona to execute a prisoner who lost a Supreme Court battle challenging the experimental lethal drug cocktail. Duration: 00:55 Video provided by AFP
Powered by NewsLook.com
China's Ageing Millions Look Forward to Bleak Future

China's Ageing Millions Look Forward to Bleak Future

AFP (July 24, 2014) — China's elderly population is expanding so quickly that children struggle to look after them, pushing them to do something unexpected in Chinese society- move their parents into a nursing home. Duration: 02:07 Video provided by AFP
Powered by NewsLook.com

Search ScienceDaily

Number of stories in archives: 140,361

Find with keyword(s):
 
Enter a keyword or phrase to search ScienceDaily for related topics and research stories.

Save/Print:
Share:  

Breaking News:
from the past week

In Other News

... from NewsDaily.com

Science News

Health News

Environment News

Technology News



Save/Print:
Share:  

Free Subscriptions


Get the latest science news with ScienceDaily's free email newsletters, updated daily and weekly. Or view hourly updated newsfeeds in your RSS reader:

Get Social & Mobile


Keep up to date with the latest news from ScienceDaily via social networks and mobile apps:

Have Feedback?


Tell us what you think of ScienceDaily -- we welcome both positive and negative comments. Have any problems using the site? Questions?
Mobile iPhone Android Web
Follow Facebook Twitter Google+
Subscribe RSS Feeds Email Newsletters
Latest Headlines Health & Medicine Mind & Brain Space & Time Matter & Energy Computers & Math Plants & Animals Earth & Climate Fossils & Ruins