gms | German Medical Science

22. Jahrestagung der Gesellschaft für Arzneimittelanwendungsforschung und Arzneimittelepidemiologie (GAA)

Gesellschaft für Arzneimittelanwendungsforschung und Arzneimittelepidemiologie

03.12. - 04.12.2015, Dresden

DOACs – whom for? Secondary data analysis of current prescription trends

Meeting Abstract

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Gesellschaft für Arzneimittelanwendungsforschung und Arzneimittelepidemiologie e.V. (GAA). 22. Jahrestagung der Gesellschaft für Arzneimittelanwendungsforschung und Arzneimittelepidemiologie. Dresden, 03.-04.12.2015. Düsseldorf: German Medical Science GMS Publishing House; 2015. Doc15gaa05

doi: 10.3205/15gaa05, urn:nbn:de:0183-15gaa055

Veröffentlicht: 9. Dezember 2015

© 2015 Eichler et al.
Dieser Artikel ist ein Open-Access-Artikel und steht unter den Lizenzbedingungen der Creative Commons Attribution 4.0 License (Namensnennung). Lizenz-Angaben siehe



Background: In 2014, the cost for antithrombotic drugs reimbursed by German health care funds rose by 22% to 1.4 bill. Euros [1].

This increase is mainly due to the continuing rise in prescriptions of direct oral anti-coagulants (DOACs), whose superiority to the older vitamin K antagonists (VKAs) has been challenged [2].

There are substantial regional differences in the use of DOACs; e.g., both a north-south and a west-east divide have been observed, with higher prescription rates in the south and in the east of Germany [3].

Materials and Methods: Secondary data on prescription records for all AOK insurees between 2010 and mid-2015 have been analysed for prescription volume (DDD) and cost of the following three anti-coagulant therapy groups: heparins, VKAs, DOACs.

Results: The DOAC volume continues to rise, without a concomitant drop of VKA volumes. This gives rise to the hypothesis that new segments of the population are being addressed with DOACs. Indeed, two thirds of VKA recipients during 2014 have already been treated with VKAs in 2011. Only 22% of DOAC recipients in 2014 had been treated with a VKA in 2011.

The choice of therapy differs substantially with age and sex; in particular, men receive a substantially higher share of VKAs then women.

Regional hotspots of DOAC use can be found in Baden-Württemberg, Hamburg and Saxony, whereas North-Rhine-Westphalia shows the lowest share of DOACs.

Conclusion: Our investigation extends previous results on regional disparities, based on a large number of patients. Clear messages on regional east/west or north/south divisions cannot, however, be confirmed. The initial hypothesis that DOACs are mainly prescribed to patients without previous anticoagulant therapy has been corroborated. While the number of new VKA patients is still substantial, the number of switches of regime remains low.

As has been observed in other areas (e.g., cardiovascular therapy), men tend to receive the newer therapies more frequently than women. The rationale of physicians making such distinctions in their therapeutical choice remains unclear.


Schwabe U, Paffrath D, eds. Arzneiverordnungsreport 2015. Heidelberg etc.; 2015.
Wille H.Neue Antikoagulanzien in der Therapie des Vorhofflimmerns. Externer Link
Glaeske G, Schicktanz C. Barmer GEK Arzneimittelreport 2014. Berlin; 2014.