Broad consensus warfarin needs review, improvement

In a submission to the review chaired by former PBAC chair Professor Lloyd Sansom, the Baker IDI Heart and Diabetes Institute said many Australians with atrial fibrillation (AF) did not see their stroke risk reduced via warfarin.

“We estimate that around 30% of the population with indications for oral anticoagulation are either not suitable for warfarin therapy or unduly exposed to risk with its use,” the institute’s director Professor Garry Jennings said.

He said community-based surveys of warfarin patients showed rates of time in therapeutic range (TTR) that were “far short” of clinical trial results.

There was a need for “more widespread availability of point of care testing and disease management programs”, particularly in remote areas, as well as better patient and provider education, he wrote.

“New anticoagulants have been developed… driven by the problematic nature of warfarin