Table 2.

Changes in hospitalised AF-related stroke incidence, prescribing of oral anticoagulants and budget impact

	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.