These problems mean doctors are sometimes reluctant to prescribe warfarin. Now the National Institute for Health and Clinical Excellence (Nice) has recommended that doctors in England and Wales should be able to prescribe a new drug called apixaban, marketed under the brand name Eliquis. Although only draft guidance, it is unlikely Nice will receive objections. The decision comes 18 months after a large study found the twice-daily pill to be even more effective at preventing stroke than warfarin, while reducing the number of bleeds. Compared to warfarin, it cut the number of strokes by 21 per cent and the number of major bleeds including brain haemorrhage by 31 per cent. Deaths from all causes were 11 per cent lower. Compared to taking nothing, it is likely that apixaban cuts the odds of stroke by about 80 per cent. Apixaban is the third new generation stroke-prevention drug recommended by Nice recently. The other two, rivaroxaban and dabigatran, are similarly effective. All cost a little over 2 a day, compared to about 1 a day for warfarin. Professor Carole Longson, from Nice, said its appraisal committee had heard from patient experts that warfarin can have a greater impact on a persons quality … Continue reading
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