More than 400,000 Belgians took oral blood thinners – medicines that are mainly used to prevent thrombosis in patients with atrial fibrillation – in 2023, according to a new study by the Health Fund of the Christian Mutuality (CM).
Atrial fibrillation is a heart rhythm disorder in which the atria of the heart contract rapidly and irregularly. Patients suffering from this condition are often prescribed oral blood thinners to prevent blood clots from forming.
There are two types of anticoagulants: vitamin K antagonists (VKAs) and direct oral anticoagulants (DOACs).
Until 2009, vitamin K antagonists were the only type of oral blood thinner on the market, but CM said that they require precise dosing that must be continuously monitored through blood coagulation analysis and subsequent dosage adjustments, which often makes it invasive for the patient.
Since 2009, there has been a more user-friendly alternative: direct oral anticoagulants. "This type of medication does not need to be monitored via blood coagulation analyses, but the patient does need to take it more accurately," said CM chair Luc Van Gorp.
"A missed dose can quickly have serious consequences, which patients are not always aware of," he stressed. "Additionally, they are also more expensive than VKAs and are prescribed more often. This pushes up the cost to the compulsory health insurance system."
Between 2008 and 2023, the number of CM members using oral anticoagulants increased by 6% per year. The study also shows a shift from VKAs to DOACs: in 2023, 91% of patients taking oral anticoagulants used direct oral anticoagulants.
Additionally, the study found that patient compliance is not optimal, regardless of the type of anticoagulant they use.
"It is important to find accessible solutions to the difficulties patients experience during their treatment. Only then can we give everyone access to safe treatments that reduce the risks of inadequate compliance," said Van Gorp.
