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Rapid DOACs rollout for AF ‘six years ahead of target’

Rapid DOACs rollout for AF ‘six years ahead of target’

A rapid rollout of direct oral anticoagulants (DOACs) for people with atrial fibrillation (AF) has saved thousands of lives and is six years ahead of target, NHS England has said.

In a keynote speech to the King’s Fund annual conference later today, NHS chief executive Amanda Pritchard will highlight estimates that almost 17,000 strokes had been prevented in the past 18 months.

The NHS drive to rapidly expand the use of DOACs included a new Investment and Impact Fund (IIF) indicator for 2022/23 to encourage GPs to consider switching all patients on DOACs onto edoxaban to save costs.

Some had warned the move would be time-consuming for PCNs but thresholds were revised, which seemed to alleviate some of the concerns.

At a board meeting earlier this month, increased use of DOACs was cited as one reason for an increase in prescribing costs in primary care but the NHS said commercial deals struck on the drugs had led to millions of pounds of savings.

Latest NHS figures show that since January 2022, around 460,000 more people have started taking anticoagulant drugs with more than 24 million prescriptions given to patients – preventing an estimated 17,000 strokes and 4,000 deaths.

The drive followed NICE guidance recommending four DOACs as clinical and cost-effective treatments with NHS commissioning guidance in January 2022, stating edoxaban should be the preferred option.

In 2019 a target of treating 90% of patients with atrial fibrillation with DOACs by 2029 was set but this has already been reached Ms Pritchard.

Part of the work has been around partnerships between the health service and pharmaceutical industry to increase opportunistic testing, NHS England said.

This includes £45m invested in ‘Detect, Protect, Perfect’ initiatives for local NHS teams to launch innovative schemes to diagnose and treat patients with atrial fibrillation.

One such initiative launched at 12 GP practice sites in Leicestershire enables patients to opportunistically test for atrial fibrillation using a handheld device while they sit in the waiting room.

‘Thanks to hardworking NHS teams across the country, the rapid roll-out of these drugs is a monumental step forward in providing the best possible care for patients with cardiovascular conditions,’ Ms Pritchard said.

‘It is also part of a major NHS drive to prevent ill health in the first place – we want to reduce the number of people living with major illness and save thousands more lives and from the rollout of these drugs to blood pressure checks in barber shops and supermarkets, we are ensuring we are doing all we can to achieve this.’

Professor Azeem Majeed, a GP and professor of primary care and public health at Imperial College London, said the rapid deployment of DOACs was a very positive step in cardiovascular disease management.

‘Meeting a national public health target six years early is a testament to the hard work of primary care and hospital teams.

‘The achievement showcases a successful implementation of evidence-based intervention on a large scale and reaffirms the role of the NHS as a leader in healthcare innovation and preventive medicine.

He added: ‘The innovative methods used to achieve the target could also be applied to other areas of prevention and chronic disease management.’


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Please note, only GPs are permitted to add comments to articles

Bonglim Bong 2 November, 2023 11:39 am

The ‘top secret’ pricing deal with edoxaban’s manufacturer really muddies the water. Especially as apixaban’s price has now dropped considerably.

If part of your guidance is that GPs should prescribe cost effectively; something they happen to do better than almost every other speciality; then you need to be honest and upfront with GPs about the nature of the deal.

Top secret deals cost more money in the long term. They should just be banned from the public sector, even if on the face of it there were to be a higher price initially.

Dave Haddock 2 November, 2023 12:00 pm

Meanwhile a nine month wait locally to see an NHS Cardiologist for suspected arrhythmia.

Charles Perrott 2 November, 2023 12:43 pm

Six years ahead of target? Surely ten years behind.
Can remember coming under the cosh from prescribing advisors for prescribing these drugs when they first became available.

fareed bhatti 2 November, 2023 12:55 pm

Another example of NHSE taking credit for something they had very little brains or effort involved in.
Yes Amanda -your foresight and brilliance is blinding.
Shall we try and do something to fix the rest of the flustercluck!

Darren Tymens 2 November, 2023 2:52 pm

Why is NHSE always surprised when we overperform? We are doing it every day.

Also, the backroom deal and incentivisation of Edoxaban over other DOACs strikes me as unethical.

David Jarvis 3 November, 2023 9:17 am

I hadn’t noticed a rollout of DOACs. Just a jobbing GP keeping up with current best practice in preventative medicine. So invisible NHSE action produces results. Perhaps if NHSE became even more invisible we would get even better results?

Michael Green 4 November, 2023 12:35 pm

All fun and games till the first GP to get sued when patient dies after being switched to a DOAC without a reversing agent

James Weems 6 November, 2023 4:04 pm

This smacks of Johnson taking credit for the vaccine. Rollout.