OBJECTIVES:

Four novel oral anticoagulants (NOACs) were approved and included in the National Reimbursement Drug List in China in recent years. The prescribing patterns and preferences for NOACs in China are unclear. The study aims to describe the prescribing patterns and preference attributes affecting physicians’ choice on NOAC selection for atrial fibrillation (AF) or venous thromboembolism (VTE) in real-world clinical practice in China.

METHODS:

We are conducting a nationwide quantitative and qualitative survey among physicians from 30 top tier hospitals in China, where physicians are treating at least five AF or VTE patients weekly and familiar with NOACs. Information on treatment selections and attributes of preferences are collected and analyzed. A total of 53 physicians will be surveyed, mostly from Department of Cardiology (AF) and Department of Vascular Surgery (VTE).

RESULTS:

According to the results from pilot interviews, where physicians’ initial choice of NOACs in patients with AF or VTE in the past three months was on average 30% (rivaroxaban), 50% (edoxaban), 2.5% (apixaban) and 12.5% (dabigatran). Edoxaban was often chosen for patients requiring reduced doses, e.g., patients with low weight, impaired renal function, or use of certain P-glycoprotein inhibitors. Rivaroxaban was selected for its long-term use history and low price. Dabigatran was less often selected for its twice-daily (BID) dosing and high price. Apixaban was the least used NOAC due to no supply in or late entry to hospitals. Warfarin was mostly used in patients who could not take NOACs. Patients’ knowledge of the disease severity was the most influential attributes for adherence to NOACs.

CONCLUSIONS:

This research could help us better understand the prescribing pattern of and preferences for NOACs among physicians treating AF or VTE patients in China.