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Patterns in anticoagulant utilization in the Czech Republic during 2007–2017

  • J. Maly
  • S. Dvorackova
  • E. Zimcikova
  • A. A. Kubena
  • J. Kolar
  • J. Vlcek
  • M. Penka
  • K. Mala-LadovaEmail author
Article

Abstract

Direct oral anticoagulants (DOACs) have gradually entered the Czech market as alternatives to vitamin K antagonists and parenteral anticoagulants since 2008. Considering the eventual changes, the aim was to evaluate drug use and expenditure patterns on anticoagulants in the Czech Republic. A retrospective utilization study was conducted retrieving data from the State Institute for Drug Control database, including reports on drug supplies from distributors with anatomical therapeutic chemical classification (ATC) codes B01AA, B01AB, B01AE, B01AF, and B01AX. The utilization on national level was expressed as the ratio of the number of defined daily doses per 1000 inhabitants per day (DDD/TID). Expenditures on all anticoagulants were also assessed. Data was analyzed using PASW (version 18.0). Between January 2007 and December 2017, the national anticoagulant utilization rate increased continuously from 14.15 to 27.67 DDD/TID. The use of DOACs was 0.002 DDD/TID in 2008, increased to 6.04 DDD/TID in 2017. Warfarin utilization, after a small decrease in 2008, has shown nearly stable levels in the recent years (70.9% of all anticoagulants; mean 11.55 DDD/TID over the last 5 years), while its increase was halted by the spread of DOACs utilization (p < 0.05). In 2017, over half of the expenditures (51.1%) were due to oral anticoagulants, whereof 47.6% was related to DOACs. The results reflected a growing utilization and increasing costs of all anticoagulants, especially in DOACs at the expense of warfarin. Still, additional information regarding patient persistence and prescribing patterns is needed for a better understanding of oral anticoagulant utilization.

Keywords

Anticoagulants Drug utilization Warfarin DOAC Czech Republic 

Notes

Acknowledgements

The study was supported by Charles University (Project SVV 260 417). The authors express their grateful thanks especially to Dr. Eva Jirsova and Dr. Kamil Kalousek from the State Institute for Drug Control (SUKL) for providing the national data about drug utilization.

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Supplementary material

11239_2019_1806_MOESM1_ESM.tif (605 kb)
Supplementary material 1 (TIF 605 KB)

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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2019

Authors and Affiliations

  1. 1.Department of Social and Clinical Pharmacy, Faculty of Pharmacy in Hradec KraloveCharles UniversityHradec KraloveCzech Republic
  2. 2.Department of Clinical HematologyTeaching Hospital of Masaryk UniversityBrnoCzech Republic

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