Karel Kostev։ When First Anticoagulant Prescriptions Are Not Dispensed
Karel Kostev, Senior Scientific Principal at IQVIA, shared a post on LinkedIn about a recent article he and his colleagues co-authored, published in Journal of Cardiovascular Development and Disease, adding:
”New publication in the Journal of Cardiovascular Development and Disease.
How often is a first oral anticoagulant prescription for atrial fibrillation (AF) never dispensed?
We analysed 57,290 first prescriptions in 53,815 AF patients in Germany (2016–2025), using the IQVIA Disease Analyzer and LRx databases.
Key findings:
- Primary non-adherence (PNA), i.e. no dispensing within 30 days, occurred in 10.6 percent of prescriptions
- PNA was highest for vitamin K antagonists (14.4 percent) and lowest for apixaban and edoxaban (9.6 percent each)
- Direct factor Xa inhibitors were associated with 33 percent lower odds of PNA than vitamin K antagonists
- Prior myocardial infarction and dementia were associated with lower PNA; ischemic heart disease and hypertension with higher PNA
- Almost half of non-dispensed prescriptions were dispensed later
- Non-dispensing of the first prescription was strongly associated with later non-dispensing
General practitioners and pharmacists can use these findings to confirm early whether anticoagulation has actually started, especially for vitamin K antagonists.”
Title: Primary Non-Adherence and Associated Factors in Patients with Atrial Fibrillation in Germany: A Retrospective Cohort Study
Authors: Karel Kostev, Beate Leppert, Maximilian Peters, Henning Sievert, Marcel Konrad, Mark Luedde
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