OBJECTIVES: The availability of direct oral anti-coagulants (DOACs) has enabled additional prescriber choice for managing stroke risk in patients with non-valvular atrial fibrillation (NVAF). However, there is limited data comparing total resource utilisation associated with warfarin and apixaban use in hospitalised patients with newly-diagnosed NVAF. This study aimed to evaluate hospital length of stay (LOS), drug acquisition and administration costs, international normalized ratio (INR) monitoring and related staff contacts, in these patients.

METHODS: This was a retrospective, dual time point, cross-sectional study of medical records of hospitalised patients, newly-diagnosed with NVAF as their primary cause of admission, initiated on anticoagulation in Jersey. Data were collected around the availability of warfarin (July 2011-June 2012) and apixaban (July 2016-June 2017). Costs were expressed as 2018 GBP. Statistical analysis included descriptive statistics (t-tests, chi-squared tests) assessing differences in baseline characteristics, and Wilcoxon rank sum to test for differences between mean LOS.

RESULTS: CONCLUSIONS: This study suggests that prescribing choice should not be determined by drug acquisition cost alone. The utilisation of apixaban in hospitalised, newly-diagnosed NVAF patients led to a shorter LOS, the avoidance of INR testing and administration of enoxaparin.