embolismDespite the initial slow uptake of Novel Oral Anticoagulants (NOACs), they will still challenge warfarin as a viable treatment for Venous Thromboembolism (VTE), consulting firm GlobalData has predicted.

Lakshmi Dharmarajan, PhD, GlobalData's Senior Analyst covering cardiovascular and metabolic disorders, said that: “NOACs are increasingly being used in patients with VTE due to the drugs’ rapid onset of action and the ability to be administered in fixed doses without the need for regular coagulation monitoring.

“Among the VTE population, the fastest to adopt NOACs have been the orthopedic patient segments, for the prevention of deep vein thrombosis (DVT).”

For those with DVT, Xarelto has been demonstrated by real-world studies to have economic advantages over standard-of-care treatments.

Positive evidence includes “shorter hospital stays, in addition to the obvious clinical benefits of these drugs, [which] will encourage payers and healthcare systems to recognise their financial advantages over existing treatments,” said Dharmarajan. “For the anticoagulation market in general, a concerted effort by NOAC manufacturers to provide clinical practice evidence is absolutely essential for these drugs to challenge the 65-year legacy built by warfarin.”

Another potential benefit is the launch of several new reversal agents, which will help boost NOAC usage in the near future. Even in cost-conscious markets such as the UK, physicians envision a dramatic shift towards NOACs, at least for the majority of the VTE population.

“For NOAC developers, the next step should be to evaluate the efficacy and safety of the drugs for patients with VTE and cancer, and also for the prophylaxis of VTE. This would enable the treatment to achieve universal acceptance in the VTE population as the standard-of-care therapy,” Dharmarajan said.