OBJECTIVES Oral anticoagulants (OACs), used for stroke prevention in atrial fibrillation, include warfarin and the newer drugs (NOACs) dabigatran, rivaroxaban and apixaban. High direct drug costs of the NOACs to the healthcare payer prompt monitoring of real-world NOAC uptake patterns. This study aimed to identify factors associated with anticoagulation initiation with NOACs versus warfarin. METHODS Analyses were performed using national pharmacy claims data from a means-tested state medical services scheme. First-time initiators of an oral anticoagulant between January 2009 and December 2013 with ≥ 1 year scheme eligibility and ≥ age 50 were identified. Patients whose claims amounted to <90 days of oral anticoagulation were excluded. Patient characteristics, and number and type of concomitant medications at the time of first oral anticoagulant were recorded and considered as predictors of NOAC initiation using multivariate logistic models (odds ratios, OR and 95% CIs). RESULTS CONCLUSIONS Multiple comorbidities may be associated with lower likelihood of NOAC initiation, as recently observed in other jurisdictions. Such uptake patterns have implications for real-world cost-effectiveness and outcomes studies.