Critics of the ever-rising cost of healthcare in the United States need look no further than the rising expenses for new prescription drugs.
After all, prescription drug prices have consistently grown by around 10% each year and Americans now spend an estimated $460 billion annually on these medications. And although some are covered by insurance, patients are increasingly forced to pay for many of their prescriptions out-of-pocket.
One area where treatment costs have grown drastically is in the prevention of blood clots and strokes. Beginning in 2010, novel oral anticoagulants like Pradaxa, Xarelto and Eliquis were released to replace generic warfarin, which had been used for decades.
And with the new drugs come higher price tags: instead of paying a few dollars a month for aspirin or warfarin blood thinners, patients can now pay as much as $425 per month for top-priced Xarelto.
However, a new study out last month suggests plain old aspirin may be just as good as blood thinners like Xarelto at preventing blood clots in some patients, with fewer risks and significant savings for consumers and the healthcare system.
Canadian Study of Knee and Hip Replacement Patients
The study entitled Aspirin or Rivaroxaban for VTE Prophylaxis after Hip or Knee Arthroplasty was funded by the Canadian Institutes of Health Research and published in the February 22 edition of the New England Journal of Medicine.
One of the biggest risk factors for blood clots occurs in patients who’ve recently undergone major surgery. Therefore, researchers enrolled more than 3,400 patients who’d recently had total knee replacement or total hip replacement in the randomized study.
Participants were first given a once-daily 10 mg dose of Xarelto for the 5 days immediately following surgery. Then, they were selected to either continue the Xarelto treatment or switch to a 81 mg daily dose of aspirin.
This continued for 9 days in those who’d had knee replacement and 30 days in those who’d undergone hip replacement.
Results Show Aspirin As Effective as Xarelto
Researchers tracked the number of patients in each group that suffered a major venous thromboembolism (blood clot) event like deep vein thrombosis or pulmonary embolism over a total period of 90 days.
They found that .7% of patients suffered major blood clots in the Xarelto group, while only .6% suffered the same fate in the aspirin group. Also, 1% suffered from bleeding at the surgical site while continuing on Xarelto, while 1.3% had the same bleeding while taking aspirin.
Based on the results, the doctors recommended a new study comparing aspirin to Xarelto and other blood thinners right after surgery, without waiting until patients had already received Xarelto for 5 days.
Internal Bleeding Risks with Anticoagulants
Based on this new study, there is evidence to suggest some patients may be able to save thousands of dollars each year and receive comparable treatment by taking aspirin instead of expensive name-brand blood thinners to prevent blood clots.
However, more research is still needed and patients are cautioned to talk to their doctor before stopping or making any changes to their medication regimen.
Aside from the immense cost savings, patients must also consider the risks for internal bleeding that have surfaced with the new generation blood thinners such as Xarelto, Pradaxa and Eliquis.
Studies in recent years have shown that the chances of gastrointestinal bleeding or brain hemorrhage may be higher with these medications than with warfarin.
And, most importantly, severe internal bleeding may be harder to control in patients taking these drugs, due to the lack of antidotes like vitamin K that will stop the effects of warfarin.
Rising Trend of Bleeding Hospitalizations
As a result, more than 30,000 patients have been hospitalized in recent years for serious internal bleeding while taking Xarelto, Pradaxa or Eliquis. More than 2,500 have died.
At the time of this article, more than 30,000 lawsuits have been filed in various state and federal courts alleging uncontrollable internal bleeding from these drugs, and more than $650 million has been paid out to those injured.
Hopefully, additional studies comparing the effectiveness of aspirin to the brand name blood thinners Pradaxa, Xarelto or Eliquis will also address the internal bleeding risks and the potential for life-saving antibodies that may prevent future injury.
For more on the safety of popular blood thinning drugs, the latest FDA warnings or legal news, or to speak directly with a lawyer about your case, contact DrugNews today.
Pajer, N. 2016 Prescription Prices and Purchase Trends. Searchrx.com. (December 20, 2016). Retrieved from www.searchrx.com
Aspirin just as good as Xarelto for preventing clots after hip, knee surgery. Reuters. (February 21, 2018). www.reuters.com
Anderson, D., et al. Aspirin or Rivaroxaban for VTE Prophylaxis after Hip or Knee Arthroplasty. New England Journal of Medicine. (February 22, 2018). Retrieved from www.nejm.org
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