Form Restrictions May Worsen Atrial Fibrillation Outcomes

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FRIDAY, August 12, 2022 (HealthDay News) — Limiting access to nonvitamin K antagonist oral anticoagulants (NOACs) may exacerbate blood thinner underuse and increase the risk of adverse health effects, such as strokes, in patients with newly diagnosed atrial fibrillation, according to a study published online August 4 in the American Journal of Managed Care.

Bo Zhou, Ph.D., of the University of Southern California at Los Angeles, and colleagues identified a sample of Medicare beneficiaries with an incident diagnosis of atrial fibrillation (2011 to 2015) and followed them through 2016 or their death. Blood thinner use and health outcomes were compared by NOAC Medicare Part D plan coverage.

Researchers found that beneficiaries enrolled in Part D plans that restricted access to NOACs had a lower likelihood of NOAC use, poorer compliance conditional on NOAC use, and longer delays in treatment. filling an initial prescription within 30 days of diagnosis of atrial fibrillation. Restricted diets were also associated with a higher overall risk of mortality, stroke, and transient ischemic attack (adjusted relative risk, 1.098).

“Insurers’ efforts to control health spending increasingly rely on restricting access to expensive therapies. In the case of NOACs, these policies can be wise and foolish,” a co-author said in a statement. “All drug benefit managers and Medicare Part D plans should continually review their formulary policies to ensure patients have timely access to effective medications.”

One author disclosed financial ties to the biotech industry.

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