Lead author Dr. G. Caleb Alexander, a research scientist in the Johns Hopkins Bloomberg School of Public Health, used data from the IMS National Disease and Therapeutic Index, a nationally representative audit of ambulatory providers.
Alexander and colleagues quantified patterns of oral anti-coagulant -- dabigatran and warfarin -- use among study participants from 2007 to 2011.
Pharmacy expenditures for warfarin and dabigatran were quantified using a nationally representative audit of retail, mail order and long-term care pharmacies, Alexander said.
The National Institutes of Health says patients with atrial fibrillation have an increased risk of stroke and previous research indicated use of oral anti-coagulants may reduce the risk of stroke by up to two-thirds.
The study, published in the journal Circulation: Cardiovascular Quality and Outcomes, found despite rapid adoption of dabigatran for the treatment of atrial fibrillation, a large proportion of patients -- 2-in-5 -- did not receive oral anti-coagulant therapy.
In addition, although the majority of dabigatran utilization was for its U.S. Food and Drug Administration-approved indication, atrial fibrillation, an increasing proportion of use was for off-label indications such as venous thromboembolism -- blood clot.