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Direct-Acting Oral Anticoagulants: Treatment Considerations
For patients at risk for thromboembolic complications who have trouble with adherence to warfarin therapy or prefer not to be treated with warfarin, newer direct-acting oral anticoagulants may be an option. Michael A. Evans, BS, RPh, explores the advantages and limitations of treating patients with direct-acting oral anticoagulants.
Mr Evans remarks that unlike with warfarin, regular monitoring is not required with the direct-acting oral anticoagulants, as their anticoagulant effect is predictable. There are no known food interactions with the direct-acting oral anticoagulants; however, drug-drug interactions are still of concern.
The direct-acting oral anticoagulants have a short half-life, and thus missed doses and a lack of patient adherence leave patients at risk for thromboembolic events within a short time frame, says Mr Evans.
Should a patient who is being treated with a direct-acting oral anticoagulant experience a thromboembolic event, it is more difficult to determine whether the event was related to a lack of adherence or drug failure, notes Mr Evans. This may be easier to determine for patients who are treated with warfarin, he adds.
Mr Evans explains that a patient’s age, their risk for bleeding events, and cost are all factors that affect a physician’s decision to treat a patient with warfarin versus a direct-acting oral anticoagulant.
Specialty Drug Costs Drive Medicare Part D Dermatology Expenditures
July 22nd 2025The rapidly increasing prescriptions for expensive specialty medications, rather than their price growth, are the primary driver of escalating dermatology Medicare Part D expenditures, necessitating policies that balance innovation, access, and affordability.
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Primary Care Doctors Lead Rising Physician Exodus From Medicare
July 21st 2025According to the American Medical Association, blame for the ongoing physician shortage may lie with overly burdensome administrative processes, an antiquated Medicare payment system, and lack of education for residents in primary care and psychiatry.
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Laundromats as a New Frontier in Community Health, Medicaid Outreach
May 29th 2025Lindsey Leininger, PhD, and Allister Chang, MPA, highlight the potential of laundromats as accessible, community-based settings to support Medicaid outreach, foster trust, and connect families with essential health and social services.
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AI Meets Medicare: Inside CMS’ WISeR Model With Sanjay Doddamani, MD, MBA
July 17th 2025Sanjay Doddamani, MD, MBA, a former senior advisor to the Center for Medicare and Medicaid Innovation, and internist and cardiologist by training, explains how the Wasteful and Inappropriate Service Reduction (WISeR) Model hopes to work, and addresses concerns about delays and denials from revamped prior authorization processes.
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