2011–2014 | 2014–2017 | Change over study period (%) | Change over study period | |
Hospitalised AF-related stroke | ||||
Total number of strokes* | 86 467 | 76 730 | −11.3% (95% CI −11.5% to −11.1%) | −9737 (95% CI −9943 to −9597) |
Cost of management in the first year after stroke (£)† | 1 154 507 384 | 1 024 498 960 | −11.3% (95% CI −11.5% to −11.1%) | −130 008 424 |
Prescription of oral anticoagulants for patients with AF | ||||
Number taking warfarin | 1 313 544 | 1 525 674 | 16.1 | 212 130 |
Number taking DOACs | 67 626 | 1 049 995 | 1452.7 | 982 369 |
Number taking any oral anticoagulation | 1 381 170 | 2 575 669 | 86.5 | 1 194 499 |
Cost of warfarin (NIC) (£) | 34 223 701 | 40 169 526 | 17.4 | 5 945 825 |
Estimated INR monitoring costs (£) | 317 877 664 | 369 213 149 | 16.1 | 51 335 485 |
Cost of DOACs (NIC) (£) | 53 089 609 | 729 274 502 | 1273.7 | 676 184 893 |
Cost of all oral anticoagulants (£) | 87 313 310 | 769 444 028 | 781.2 | 682 130 718 |
Cost of all oral anticoagulants plus monitoring (£) | 405 190 974 | 1 138 657 177 | 181.0 | 733 466 204 |
Per-patient costs by study period | ||||
Cost of all oral anticoagulant prescriptions (£) | 293 | 442 | 50.7 | 149‡ |
Cost of all oral anticoagulant prescriptions and management in the first year after hospitalised AF-related stroke (£)* | 1129 | 840 | −25.6 | −289‡ |
Numbers are rounded.
*After adjustment for AF prevalence.
†Healthcare costs in the year after stroke, including ambulance transport, MRI or CT scans, thrombolysis, acute stroke unit care, rehabilitation stroke unit care, general medical ward care, community rehabilitation, general practitioner visits, secondary prevention and therapy for early supported discharge,17 based on a cost per patient of £13 452.18 19
‡Incremental change in cost per patient.
AF, atrial fibrillation; DOAC, direct oral anticoagulant; INR, international normalised ratio; NIC, net ingredient cost.