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More Medicare Beneficiaries Are Initiated on Direct Oral Anticoagulants According to a Recent Avalere Analysis

Summary

New Avalere analysis evaluates the trends in baseline patient characteristics among Medicare fee-for-service beneficiaries with stand-alone Part D coverage who initiated a direct oral anticoagulant during the period 2013–2017.

The analysis provides additional information about the increased utilization of DOACs and key demographic and clinical characteristics of these patients.

Avalere evaluated trends in direct oral anticoagulant (DOAC) use in a 100% sample of the Medicare fee-for-service (FFS) population with stand-alone Part D coverage and the characteristics of the patients initiating DOACs.

Key Findings

Selected primary findings from this analysis include:

  • The number of DOAC users in stand-alone Part D plans grew year over year from 2013 to 2017 (Figure 1)
  • The percentage of DOAC users in each calendar year with a prior history of DOAC use increased from 40% in 2013 to 63% in 2017
  • In 2017 (the latest data year available), the mean age of a Medicare beneficiary treated with a DOAC was 76 years and 54% were female
  • The mean Charlson Comorbidity Index (CCI) score and CHA2DS2-VASc score increased for DOAC users from 2013–2017 (Figures 2 and 3)
Direct oral anticoagulants trends, figure 1
Direct oral anticoagulants trends, figure 2
Direct oral anticoagulants trends, figure 3

Funding for this analysis was provided by Bristol–Myers Squibb and Pfizer. Avalere maintained full editorial control.

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Methodology

This research was conducted by Avalere Health and utilized the 100% sample of Medicare Part A and Part B FFS claims data and prescription drug event data for stand-alone Part D plans. The cross-sectional design was employed to identify a cohort of Medicare FFS beneficiaries with at least 1 prescription fill for a DOAC during each calendar year (2013–2017). The first fill of a DOAC (apixaban, dabigatran, edoxaban, rivaroxaban) served as the index date for that calendar year.

Beneficiaries were required to have at least 12 months of continuous Medicare Parts A/B/D enrollment prior to the index date. Baseline patient characteristics were evaluated among DOAC users for each calendar year.

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