Delayed treatment initiation of oral anticoagulants among Medicare patients with atrial fibrillation

American Heart Journal Plus: Cardiology Research and Practice, 2024

Time is of the essence when it comes to prescribing oral anticoagulants (OACs) for stroke prevention, particularly among patients with atrial fibrillation, a condition that contributes to approximately 15% of strokes in the US. Yet despite guideline recommendations for the timely use of OACs, many patients with atrial fibrillation experience delays in treatment that could impact their health. Further, barriers to accessing OACs, such as formulary restrictions or reduced interactions with specialty cardiologists, may disproportionately affect patients who belong to certain racial, ethnic, or socioeconomic groups.

An Analysis Group team led by Vice President Dominick Latrémouille-Viau and Manager Aolin Wang collaborated with researchers from Pfizer and Bristol Myers Squibb on a Medicare claims data study aimed at identifying the factors that could contribute to delays in OAC initiation. In an article describing their findings, the researchers compare patients newly diagnosed with atrial fibrillation who received timely OACs with those who experienced a delay of more than three months in their prescription. The authors conclude that, among others, factors such as Black and Native American race and formulary restrictions such as higher formulary tiers and a requirement for prior authorization were found to be associated with delayed OAC initiation.

The article, “Delayed treatment initiation of oral anticoagulants among Medicare patients with atrial fibrillation,” was published in American Heart Journal Plus: Cardiology Research and Practice.

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Authors

Luo X, Chaves J, Dhamane AD, Dai F, Latrémouille-Viau D, Wang A