MMSL X:X | DOI: 10.31482/mmsl.2025.002

TRENDS IN ORAL ANTICOAGULANT PRESCRIPTION PATTERNS IN THE CZECH REPUBLIC: A RETROSPECTIVE ANALYSIS OF 2019–2024Original article

Tomas Veleta ORCID...1*, Jiri Vlcek ORCID...2, Jiri Cyrany ORCID...3, Radovan Maly ORCID...4, Tomas Soukup ORCID...3
1 Department of Emergency Medicine, University Hospital Hradec Kralove and Faculty of Medicine, Hradec Kralove, Charles University, Czech Republic
2 Department of Social and Clinical Pharmacy, Faculty of Pharmacy in Hradec Kralove, Charles University, Czech Republic
3 2nd Department of Internal Medicine - Gastroenterology, University Hospital Hradec Kralove and Faculty of Medicine, Hradec Kralove, Charles University, Czech Republic
4 1st Department of Internal Medicine - Cardioangiology, University Hospital Hradec Kralove and Faculty of Medicine, Hradec Kralove, Charles University, Czech Republic

Background: The patterns of oral anticoagulant (OAC) prescription have significantly changed in recent years, with direct oral anticoagulants (DOACs) gradually replacing warfarin. While this transition occurred earlier in some countries, limited data are available about its timeline in the Czech Republic.

Objectives: This study aimed to analyse trends in OAC prescriptions in the Czech Republic from 2019 to 2024, focusing on the shift from warfarin to DOACs and the patterns of utilisation of individual DOACs.

Methods: A retrospective analysis was conducted using national electronic prescription data from the State Institute for Drug Control (SÚKL). Annual drug consumption is presented as defined daily doses per thousand inhabitants per day (DDD/TID).

Results: Total OAC utilisation increased from 18.83 to 26.70 DDD/TID between 2019 and 2024 (p < 0.01), with an average of 22.99 ± 3.05 DDD/TID. DOACs surpassed warfarin in total prescriptions in 2021. Rivaroxaban (6.84 ± 3.00 DDD/TID) and apixaban (5.24 ± 2.43 DDD/TID) exhibited the highest growth, while dabigatran utilisation (3.00 ± 0.66 DDD/TID) showed a halt in increase after 2022.

Conclusion: DOACs have progressively replaced warfarin in the Czech Republic, but this transition occurred later than in other developed countries. This shift was likely influenced by local changes in prescribing restrictions. Further research is warranted to evaluate prescription patterns based on specific indications.

Keywords: DOACs; warfarin; anticoagulants; prescription trends; drug utilisation; Czech Republic

Received: February 24, 2025; Revised: April 16, 2025; Accepted: April 24, 2025; Prepublished online: April 29, 2025 

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