Evidence map›Paper›PMID 29274228›Full record

ArticleHealthcare policy = Politiques de sante2017

Prior Authorization and Canadian Public Utilization of Direct-Acting Oral Anticoagulants.

Lulu Gao, Mina Tadrous, Sandra Knowles, Muhammad Mamdani, J Michael Paterson, David Juurlink, Tara Gomes

2 registry-linked trialsAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Healthcare policy = Politiques de sante, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 2 registered trials, which are not on this map. Cited by 5 papers.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT06844227 recruitingnot on this mapstarted 2021, after this paper: background citation

Perioperative Anticoagulant Use for Surgery Evaluation -Virtual Visit (PAUSE-Virtual), a Simple Perioperative Anticoagulant Management Approach, Replacing a Resource-intensive In-person Doctor-patient Consultation, With a Simple Virtual Care Model That Will Provide a New Standard of Care for Patients on a Direct Oral Anticoagulant or Warfarin and Require Elective Surgery/Procedure.

TypeobservationalSponsorMcMaster UniversityRan2021 to 2026Enrolled1,780ConditionsAtrial Fibrillation (AF)
NCT06957366 narecruitingnot on this mapstarted 2025, after this paper: background citation

Perioperative Anticoagulant Use for Surgery Evaluation -2 (PAUSE-2) Study Patients Receiving a Direct Oral Anticoagulant (DOACs-Dabigatran, Rivaroxaban, Apixaban or Edoxaban) and Needing Elective High-Bleed-Risk Surgery or an Invasive Procedure: A Randomized Control Trial

TypeinterventionalSponsorMcMaster UniversityRan2025 to 2027Enrolled920ConditionsAtrial Fibrillation (AF), VTEArmsPAUSE Perioperative DOAC Management, ASRA Perioperative DOAC Management
3 · Its place in the literature

Who cites it

5 citing papers in PubMed.

  1. Article
  2. Article
  3. Reimbursement and use of oral anticoagulants during 2014-2022 - A register-based study.Exploratory research in clinical and social pharmacy · 2023
    Article
  4. Article
  5. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors.

Lulu GaoLeslie Dan Faculty of Pharmacy, University of Toronto, Toronto, ON.
Mina TadrousLeslie Dan Faculty of Pharmacy, University of Toronto, Institute for Clinical Evaluative Sciences, Toronto, ON.
Sandra KnowlesLi Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, ON.
Muhammad MamdaniLeslie Dan Faculty of Pharmacy & Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, ON; Department of Medicine, St. Michael's Hospital, Toronto, ON.
J Michael PatersonInstitute for Clinical Evaluative Sciences, Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, ON; Department of Family Medicine, McMaster University, Hamilton, ON.
David JuurlinkSunnybrook Research Institute, Sunnybrook Health Sciences Centre, Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, ON.
Tara GomesLeslie Dan Faculty of Pharmacy & Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, ON; Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, ON.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeProvincial public drug formularies in Canada have different mechanisms for reimbursement of direct-acting oral anticoagulants (DOACs). We investigate how these differences influence DOAC utilization and expenditure across the country.

methodsWe conducted a population-based, cross-sectional study of all out-patient prescriptions for OACs dispensed to public beneficiaries between January 1, 2010, and June 30, 2015. We calculated quarterly rates of OAC use and expenditures stratified by OAC type and province.

resultsThe greatest increase in quarterly rates of DOAC utilization occurred in provinces with more liberal mechanism of drug coverage: Ontario by 462%, Alberta by 425% and Quebec by 1,924%. This translated to increased expenditure on overall OAC by 270%, 204% and 390%, respectively. In contrast, provinces with more stringent mechanisms had low rates of DOAC utilization and expenditure.

conclusionsDOAC utilization and expenditure is considerably different across Canada, associated with provincial difference in reimbursement mechanism.

Indexed as

Reimbursement MechanismsAdministration, OralAnticoagulantsCanadaCross-Sectional StudiesHealth ExpendituresHumansAnticoagulants

Identifiers

PMID29274228
PMCPMC5749525

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC
Read underepoch 390

Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.