Yan, Vincent KC; Li, Hang-Long; Wei, Li; Knapp, Martin RJ; Wong, Ian CK; Chan, Esther W; (2023) Evolving Trends in Consumption of Direct Oral Anticoagulants in 65 Countries/Regions from 2008 to 2019. Drugs , 83 pp. 315-340. 10.1007/s40265-023-01837-0.

Preview

Text Wei_IQVIA DOACs_Manuscript_REVISED_v2_20230117_clean.pdf Download (2MB) | Preview

Abstract

Background: Direct oral anticoagulants (DOACs) have been increasingly utilised over warfarin. However, little is known about the relative consumption trends and costs of each DOAC at the global level. / Methods: An ecological study using pharmaceutical sales data from IQVIA-MIDAS database was used to estimate consumption and cost of individual DOACs in 65 countries from 2008 to 2019. Consumption was estimated from the volume of DOACs sold, expressed as defined-daily-dose/1000-inhabitants/day (DDDTID). Compound and absolute annual growth rates were reported to quantify consumption changes over time. Costs were estimated as manufacturer price per day-of-therapy. / Results: Global consumption of dabigatran, rivaroxaban, apixaban and edoxaban were 0.31, 1.05, 1.08 and 0.78 DDDTID, respectively, in Q2–2019, compared to 0.23, 0.54, 0.21 and 0.03 in Q2–2015, with highest consumption in Western Europe, Northern Europe and Oceania (18.2, 14.07, 13.14 DDDTID). In most countries (46/65, 70%), rivaroxaban contributed to most DOAC consumption (35%–100%), whereas dabigatran accounted for less than one-third. Edoxaban accounted for < 20% of the total in Northern America and Europe but contributed significant proportions in Japan (28.58%) and South Korea (31.37%). Longer median time-to-adoption from FDA approval for apixaban and edoxaban was observed. Costs of all DOACs were ~2–4 times higher in the USA, Puerto Rico and Thailand than in other countries. / Conclusions: Regional differences exist in consumption pattern and trends of individual DOACs over the past decade. Consumption of rivaroxaban and apixaban overtook dabigatran in most countries, whereas use of edoxaban remains limited except in East Asian countries. The USA pays higher prices for DOACs than other countries. / Key Points: Little is known about the consumption trends and costs of each direct oral anticoagulants (DOAC) at the global level. Consumption and cost of individual DOACs were estimated in 65 countries from Q1–2008 to Q2–2019. Consumption of rivaroxaban and apixaban overtook dabigatran in most countries, edoxaban use remains limited to East Asian countries The USA, Puerto Rico and Thailand paid higher prices for DOACs than other countries.

Download activity - last month

Export as JSONXMLCSV

Download activity - last 12 months

Export as JSONXMLCSV

Downloads by country - last 12 months

Export as CSVXMLJSON

Archive Staff Only

View Item