NHS Greater Glasgow & Clyde Area Drug and Therapeutics Committee
Greater Glasgow and Clyde Medicines
Medicines Update

PostScript 79 (Jan 2014) Novel Oral Anticoagulants

Novel oral anticoagulants

The Heart MCN has proposed a strategy to offer prescribers a choice of novel oral anticoagulant (NOAC) or warfarin for patients newly diagnosed with non-valvular atrial fibrillation (AF) requiring anticoagulation. The clinical rationale is acknowledged, but such a strategy also has cumulative financial implications and requires consideration as part of the longer-term financial planning for NHSGGC.


The Board’s Prescribing Management Group recommends that until the 2014/15 plan is agreed, the Formulary position for the NOACs is unchanged:

  • NOACs are available for patients poorly controlled on warfarin (identified by GCAS, spending <60% time in therapeutic range) or warfarin allergy;  
  • NOACs remain non-Formulary for new patients
  • Patients with a new AF diagnosis who require anticoagulation should start warfarin unless contraindicated.   


Updates to this advice will be communicated through future editions of PostScript as it becomes available. Supporting information for prescribing these medicines will accompany letters from GCAS advising GPs of when a switch in anticoagulant treatment might be appropriate.


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