In Ireland, the National Centre for Pharmacoeconomics, in collaboration with the Health Service Executive (HSE), considers the cost-effectiveness of all new medicines following an application for reimbursement under the community drugs schemes (CDS). The General Medical Services (GMS) scheme is the largest of the CDS. In 2008, dabigatran etexilate (DBG) and rivaroxaban (RIV) received positive reimbursement decisions for their licensed indication of venous thromboembolism (VTE) prophylaxis in adults after total hip- and total knee-replacement. OBJECTIVES: The objective was to analyse prescribing patterns of DBG and RIV on the GMS scheme in Ireland in 2010. METHODS: A retrospective analysis of the GMS prescribing database was performed. Analysis was performed using SAS (v9.1, SAS Institute Inc. Cary, US). RESULTS: 1098 patients had received DBG.  Of these, 37.34% received it for longer than the maximum licensed duration of 35 days. Indeed, 15.94% received it for longer than 3 months and 7.56% for longer than 6 months. 1948 patients had received RIV. Of these, 25.77% had received it for longer than the maximum licensed duration of 35 days. Indeed, 2.1% had received it for longer than 3 months and 0.36% for longer than 6 months.   CONCLUSIONS: This indicates that DBG and RIV may have been prescribed for unlicensed indications (for which positive reimbursement decisions have not yet been issued).  Such indications include stroke prevention in AF and VTE treatment. There are efficacy, safety and budget impact concerns surrounding unlicensed prescribing.  Also, should their licenses be extended in the future, prescribing for such indications may increase regardless of reimbursement decisions. There exists a need to introduce a policy in which drugs are only reimbursed for those indications which have received positive reimbursement decisions.