OBJECTIVES: As populations age the prevalence of Atrial fibrillation (AF) increases, escalating stroke risk. AF is primarily managed using oral anticoagulants (OAC). Warfarin, the traditional anticoagulant prescribed, is considered cost effective from the health payers’ perspective, however has considerable add-on costs for patients owing to monitoring requirements. Thus the emergence of Direct Oral Anticoagulants (DOACs) as safe and effective alternatives to warfarin is attractive for patients and clinicians. Nevertheless the high drug cost of DOACs relative to warfarin means their reimbursement in public health care systems faces some adversaries: budget implications and concerns over safety have hindered the avocation of their use. This study aims to ascertain GPs’ attitudes and experience towards oral anticoagulants as prescribers. METHODS: Primary data is collected using a dedicated postal questionnaire to all General Practitioner practices in Ireland. The survey consisted of 18 questions. A sample frame of 1,522 GPs was created. There was a 22% response rate. A probit regression was estimated. RESULTS: Probit regression results show that GP demographics as well as the characteristics of the practice significantly affect prescribing decisions. The age of the GP and larger GP practices increase the likelihood of prescribing OACs. Co-morbidities such as renal impairment and patient characteristics have also been found to significantly affect prescribing decisions. Patient characteristics need to be considered as DOACs are expensive so to achieve cost effectiveness and value for money we need to ensure they are being prescribed to the right patients at the right time. CONCLUSIONS: As populations’ age and conditions such as AF becomes more prevalent, patients’ demands for the latest drug or technology increase thus placing increasing pressures on the financing and delivery of health care. GPs are gatekeepers for prescribing however them ensuring the right patient receives the right treatment in a cost effective manner continues to be a challenge.