Evidence map›Paper›PMID 30521639›Full record

Trial reportPloS one2018

Rapid and substantial increases in anticoagulant use and expenditure in Australia following the introduction of new types of oral anticoagulants.

Alice Morgan, Grace Joshy, Andrea Schaffer, Tracey-Lea Laba, Melisa Litchfield, Sallie Pearson, Emily Banks

Open access · goldAbstract readRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in PloS one, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 17 papers.

0numbers the graph read from it
0cells of the map it votes in
17citing papers in PubMed
3.8field-weighted citation impact, top 5% of its field
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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

17 citing papers in PubMed, 38 citations in OpenAlex.

  1. Trial
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  3. Article
  4. Article
  5. Review
  6. Review
  7. Reimbursement and use of oral anticoagulants during 2014-2022 - A register-based study.Exploratory research in clinical and social pharmacy · 2023
    Article
  8. Article
  9. Article
  10. Article
  11. Article
  12. Observational
  13. Review
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  16. Observational
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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 at 3 institutions in 1 country.

Alice MorganNational Centre for Epidemiology and Population Health, Australian National University, Canberra, Australia.ORCID 0000-0001-7413-0519
Grace JoshyNational Centre for Epidemiology and Population Health, Australian National University, Canberra, Australia.
Andrea SchafferCentre for Big Data Research in Health, University of New South Wales, Sydney, Australia.
Tracey-Lea LabaMenzies Centre for Health Policy, The University of Sydney, Sydney, Australia.
Melisa LitchfieldCentre for Big Data Research in Health, University of New South Wales, Sydney, Australia.ORCID 0000-0003-0002-7724
Sallie PearsonCentre for Big Data Research in Health, University of New South Wales, Sydney, Australia.
Emily BanksNational Centre for Epidemiology and Population Health, Australian National University, Canberra, Australia.
Australian National University · AUUNSW Sydney · AUThe University of Sydney · AU

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectivesTo quantify changes in anticoagulant use in Australia since the introduction of Non-vitamin K antagonist anticoagulants (NOACs) and to estimate government expenditure.

designInterrupted-time-series analysis quantifying anticoagulant dispensing, before and after first Pharmaceutical Benefits Scheme (PBS) NOAC listing in August 2009 for venous thromboembolism prevention; and expanded listing for stroke prevention in non-valvular atrial fibrillation (AF) in August 2013, up to June 2016. Estimated government expenditure on PBS-listed anticoagulants. SETTING AND

participantsPBS dispensing in 10% random sample of Australians, restricted to continuous concessional beneficiaries dispensed oral anticoagulants from July 2005 to June 2016. Total PBS anticoagulant expenditure was calculated using Medicare Australia statistics.

main outcome measuresMonthly dispensing and initiation of oral anticoagulants (warfarin, rivaroxaban, dabigatran or apixaban). Annual PBS anticoagulant expenditure.

resultsAn estimated 149,180 concessional beneficiaries were dispensed anticoagulants (100% warfarin) during July 2005. This increased to 292,550 during June 2016, of whom 47.0%, 27.1%, 18.7% and 7.2% were dispensed warfarin, rivaroxaban, apixaban and dabigatran, respectively. Of 16,500 initiated on anticoagulants in June 2016, 24.3%, 38.2%, 30.0% and 7.5% were initiated on warfarin, rivaroxaban, apixaban, and dabigatran, respectively. Compared to July 2005-July 2013, from August 2013-June 2016, dispensings for all anticoagulants increased by 2,303 dispensings/month (p<0.001, 95%CI = [1,229 3,376]); warfarin dispensing decreased by 1,803 dispensings/month (p<0.001, 95%CI = [-2,606, -1,000]). Total PBS anticoagulant expenditure was $19.5 million (97.0% concessional) in 2008/09, of which 100% was warfarin and $203.3 million (86.2% concessional) in 2015/16, of which 11.2% was warfarin.

conclusionsThe introduction of the NOACs led to substantial increases in anticoagulant use and expenditure in Australia.

Indexed as

Administration, OralAgedAged, 80 and overAnticoagulantsAtrial FibrillationAustraliaCosts and Cost AnalysisFemaleFinancing, GovernmentHumansMaleTime FactorsAnticoagulants

Identifiers

PMID30521639
PMCPMC6283555
OpenAlexW2905067512

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

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.