■维生素K拮抗剂,尤其是华法林,一直是抗凝治疗的支柱,但自直接口服抗凝剂(DOACs)进入市场以来,其使用在许多国家有所下降.
■研究芬兰口服抗凝剂(OACs)的使用趋势,考虑DOACs的报销和房颤(AF)治疗国家治疗指南的变化。
■两者都是公共的,使用了2014-2022年期间已报销的OAC豁免的汇总数据和电子豁免的个人级别数据.2015-2016年期间的电子分配数据用于研究OAC启动。关于DOAC报销权利的数据来自公共数据。
■2014年,DOAC用户近20,000人,到2022年上升到21.4万。自2015年以来,华法林用户数量从181,000下降到2022年的59,000左右,DOAC在2019年的用户数量超过华法林。每年的DOAC总成本高于华法林成本。利伐沙班在2014-2018年期间是最广泛使用的DOAC,在2019-2022年期间是阿哌沙班。2015年,华法林(56.7%)的发起者比DOAC(43.3%)多,但2016年的结果相反(华法林39.4%,DOACs60.6%)。有权获得DOAC报销的个人人数稳步增加,2022年,由于AF,有超过196,000人有权获得此报销。
■芬兰对DOAC的采用似乎是渐进的,并且比许多其他国家慢。在2010年代,AF治疗指南在推荐DOAC方面比欧洲指南更为谨慎.DOAC的使用随着其报销限制的减少而增加。
UNASSIGNED: Vitamin K antagonists, warfarin in particular, have been the mainstay of anticoagulation therapy, but their use has declined in many countries since direct oral anticoagulants (DOACs) have entered the market.
UNASSIGNED: To examine utilization trends of oral anticoagulants (OACs) in Finland considering the reimbursement of DOACs and changes to national treatment guidelines for the treatment of atrial fibrillation (AF).
UNASSIGNED: Both public, aggregated data on reimbursed OAC dispensations and individual-level data on electronic dispensations during 2014-2022 were applied. Data on electronic dispensations during 2015-2016 were used to study OAC initiations. Data on entitlements to reimbursement for DOACs came from public data.
UNASSIGNED: In 2014, there were almost 20,000 DOAC users, rising to 214,000 in 2022. The number of warfarin users declined since 2015 from over 181,000 to around 59,000 users in 2022, DOACs exceeding warfarin in the number of users in 2019. The total DOAC costs were higher than warfarin costs each year. Rivaroxaban was the most widely used DOAC during 2014-2018, and apixaban during 2019-2022. In 2015, there were more warfarin (56.7%) than DOAC (43.3%) initiators, but the result was opposite for 2016 (warfarin 39.4%, DOACs 60.6%). The number of individuals entitled to reimbursement for DOACs has increased steadily, and in 2022, there were over 196,000 individuals entitled to this reimbursement due to AF.
UNASSIGNED: The uptake of DOACs in Finland appears to have been gradual and slower than in many other countries. During the 2010s, the treatment guidelines for AF were more cautious in recommending DOACs than the European guidelines. The use of DOACs increased as their reimbursement became less restrictive.