Strokes & Blood thinners: November 2023
Thousands of lives saved by the NHS thanks to rapid rollout of blood thinners
Thousands of lives have been saved and almost 17,000 strokes prevented, thanks to the rapid roll-out of blood-thinning drugs on the NHS, the head of the health service will announce today.
New data shows almost half a million people at increased risk of strokes have started taking life-saving direct oral anticoagulants (DOACs), in the last 18 months, following a major NHS drive to rapidly expand their use.
Since January 2022, around 460,000 more people have started taking anticoagulant drugs with more than 24 million prescriptions given to patients – preventing an estimated 17,000 strokes and 4,000 deaths.
Speaking at the King’s Fund annual conference tomorrow, the head of the NHS, Amanda Pritchard is expected to hail the “lifesaving NHS rollout” which is part of a major NHS drive on prevention, to catch more killer conditions earlier and save more lives.
The drugs stop strokes by treating and preventing blood clots in patients with atrial fibrillation, a condition that can cause an irregular and often abnormally fast heart rate, but which can be symptomless until a stroke.
Around 1.5 million people in England are living with atrial fibrillation (AF), which causes one in five strokes.
Following NICE guidance recommending four DOACs as clinical and cost-effective treatments, their accelerated roll-out means that 90% of patients with AF and at high risk of stroke are now receiving treatment, helping the NHS meet a national public health target six years early.
The programme has been made possible thanks to a series of commercial deals struck by the NHS in 2021, to ensure four potentially life-saving DOACs could reach hundreds of thousands more patients at pace.
NHS commissioning guidance in January 2022 recommended the use of the DOAC, edoxaban as a preferred option for prescribers, as the most cost effective of the four recommended DOACs making a significant contribution towards an NHS saving of more than £100 million in medicine costs.
Speaking at the King’s Fund annual conference 2023 later today (Thursday 2 November), NHS chief executive, Amanda Pritchard, will say: “It’s outstanding news that these drugs have potentially helped save thousands of lives already and prevented many more people from suffering the serious and often debilitating effects of strokes.
“Thanks to hardworking NHS teams across the country, the rapid roll-out of these drugs is a monumental step forward in providing the best possible care for patients with cardiovascular conditions.
“It is also part of a major NHS drive to prevent ill health in the first place – we want to reduce the number of people living with major illness and save thousands more lives and from the rollout of these drugs to blood pressure checks in barber shops and supermarkets, we are ensuring we are doing all we can to achieve this.
“This incredible progress has not only been transformative for patients and their families but is another vital example of the NHS using its purchasing power to deliver the latest life-saving medicines for our patients at affordable prices for the taxpayer.”
With cardiovascular disease causing a quarter of all deaths in the UK and around 1.5 million people living in England with atrial fibrillation, the NHS committed in its Long-Term Plan to increase efforts in early detection and treatment of cardiovascular conditions.
In 2019, the target of treating 90% of patients with AF with DOACs by 2029 was set, but thanks to the roll-out this milestone has already been reached, just 18 months after NHS guidance advising clinicians to prescribe DOACs for people with the condition was issued.
The target was set by the National Cardiovascular Disease Prevention System Leadership Forum, which is made up of 40 organisations including NHS England.
As part of groundbreaking agreements between NHS England and pharmaceutical industry partners, £45 million has also been invested in ‘Detect, Protect, Perfect’ initiatives, allowing local NHS teams to launch innovative schemes to diagnose and treat patients with AF.
One ‘Detect, Prevent, Perfect’ initiative launched at 12 GP practice sites in Leicestershire is providing patients with devices to opportunistically test for AF while they sit in the waiting room. If a patient is found to have atrial fibrillation using the handheld device, they will be referred for follow-on testing and treatment within 24 hours.
Niraj Lakhani, Lead Clinical Pharmacist who has helped roll out the scheme, said: “With high prevalence rates of atrial fibrillation in Leicester, it’s vital we continue to do all we can to detect and prevent strokes and the devasting impact they can have for patients and their loved ones.
“This initiative not only helps detect AF without impacting on any consultation time but also has the potential to save the health system significant amounts of money be preventing costly strokes.”
Dr Maeva May, Associate Director for Policy and Research at the Stroke Association said: “It’s fantastic news that oral anticoagulants have helped to prevent so many strokes over the last two years. AF accounts for one in five strokes and strokes in people with AF are more severe and are more likely to result in death or serious disability.
The good news is that if AF is identified it can be managed. The majority of AF related strokes are preventable with the right medication. Managing AF correctly improves people’s quality of life and is cost effective for the system. Both AF and other stroke prevention measures must continue to be prioritised regionally and nationally.”#
