Impact of cost on use of non-vitamin K antagonists in atrial fibrillation patients in Ontario, Canada View Full Text


Ontology type: schema:ScholarlyArticle     


Article Info

DATE

2018-10

AUTHORS

Sarah R. Monagle, Jack Hirsh, Vinai C. Bhagirath, Jeffrey S. Ginsberg, Jackie Bosch, Paul Kruger, John W. Eikelboom

ABSTRACT

Canadian guidelines recommend non vitamin K antagonists (NOACs) in preference to vitamin K antagonists (VKAs) for stroke prevention in patients with atrial fibrillation (AF), but NOACs are more expensive than VKAs. Canada has a universal healthcare system that covers the cost of NOACs for select patient groups. Ability to pay for NOACs may influence their use. We reviewed medical charts of Hamilton General Hospital outpatients under the age of 65 with a new diagnosis of AF who were referred for initiation of OAC therapy. We contacted these patients by phone and asked them to complete a questionnaire regarding their OAC choice, economic factors that may have influenced this choice (income, insurance) and the financial burden of OAC therapy. We included 110 patients, mean age 56 years, and 26.4% females. NOAC users had a higher median neighborhood income than VKA users (p = 0.0144, n = 110). 73 patients responded to the questionnaire. NOAC users reported higher annual household income (p = 0.0038, n = 73). Patients with private insurance were more likely to use NOACs than those without insurance (p = 0.0496, n = 73). The cost of NOACs and ability to pay is a determinant of their use Ontario patients under the age of 65. This two tiered provision of care appears to contradict the values of Canada's universal healthcare system. More... »

PAGES

310-315

Identifiers

URI

http://scigraph.springernature.com/pub.10.1007/s11239-018-1692-4

DOI

http://dx.doi.org/10.1007/s11239-018-1692-4

DIMENSIONS

https://app.dimensions.ai/details/publication/pub.1104404409

PUBMED

https://www.ncbi.nlm.nih.gov/pubmed/29873002


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