Introductie van nieuwe antistollingsmiddelen

The introduction into clinical practice of new oral anticoagulants (NOACs) as an alternative to vitamin K antagonists (VKAs), confronts patients, doctors, and reimbursement authorities with a choice to be made. In an advisory report from the Health Council of the Netherlands, prepared for the Ministry of Health, Welfare and Sport, the relative advantages and disadvantages of the NOACs versus the VKAs were analysed and discussed. The NOACs dealt with were dabigatran, rivaroxaban, apixaban and edoxaban. The Health Council concluded that, based on the positive results of the phase 3 clinical trials, the new agents should be included in the therapeutic arsenal available for anticoagulation treatment for the registered indications. There are still doubts, however, about their efficacy, safety and cost-effectiveness in the ‘real life’ Dutch population. It is therefore recommended that additional observational research is carried out together with careful introduction of the new agents, and that the professional bodies adapt their guidelines for anticoagulation treatment.

Conflict of interest: none declared. Financial support: none declared.