OBJECTIVES: Rivaroxaban, a direct oral anticoagulant (DOAC) targeting activated coagulation factor X (FXa), reduces the risk of stroke or systemic embolism in patients with nonvalvular atrial fibrillation and one or more risk factors for stroke. The aim of the study was to determine the prescribing patterns of rivaroxaban in a South African private healthcare setting.

METHODS: A retrospective drug utilisation study was conducted on a South African medical insurance administrator database for 2018. The database contained 4191138 records for medicine, medical devices and procedures. All products in ATC group B01A (Antithrombotic agents) were analysed.

RESULTS: A total of 32961 antithrombotic products were prescribed to 6036 patients (54.04% male patients) at a total amount claimed of R4697585. The average age of patients was 50.98 (SD=15.17) years. Half of the patients (52.55%) were between 40 and 59 years of age. Patients received on average 5.46 prescriptions for an antithrombotic product during the year. Acetylsalicylic acid accounted for 55.62% of all the antithrombotic agents that were prescribed. Rivaroxaban accounted for 2.18% of prescriptions. A total of 223 patients received one or more prescriptions for rivaroxaban. The Defined Daily Dose (DDD) of rivaroxaban is 20 mg. The average Prescribed Daily Dose (PDD) was 18.01 (SD=7.90) mg (females 17.65 (SD=8.22) mg and males 18.30 (SD=7.63) mg). More than half of prescriptions (53.14%) were dispensed by pharmacies or by doctors, and the rest in hospitals.

CONCLUSIONS: Few drug utilisation studies have been conducted in South Africa specifically focussing on rivaroxaban. From the current study, it seems as if the average PDDs were close to the DDD of 20 mg, but the sample size was too small to make definite conclusions. Studies where PDDs can be linked to ICD-10 codes are needed.