Why is the UK government spending billions on anticoagulants?

Question- why is the UK government spending billions on anticoagulants?

The following content is created ONLY for consideration to stimulate conversation. The numbers below will be off some, and there may be other explanations.

It seems that NHS England are seeking to award a massive new contract for oral anticoagulanti1 treatment, and it’s worth billions over the next few years. Question what is the typical spend in this area, as the figure may be large but relatively normal.

UK NICE document entitled, costing-statement-pdf-428535325.pdfii [1]which can be downloaded online, is used as a guide, below excerpts.

1-Oral anticoagulant numbers. 

Table 1: Incidence of deep vein thrombosis and pulmonary embolism

 Study populations Extrapolated populations
Age range (years) Eventsa  Populationa  Incidencea Population in EnglandbAnnual incidence

for

England

18–291,2663,883,1010.0326%9,063,9922,955
30–392,0643,838,8410.0538%7,656,4674,117
40–492,5434,093,0140.0621%8,273,0525,140
50–593,5693,585,1200.0996%6,825,8336,795
60–695,0842,874,4370.1769%5,895,09810,427
70–796,6062,015,9740.3277%3,788,61812,415
80–895,9801,100,9590.5432%2,511,79715,792*
90 and over1,579221,0780.7142%  
Total incidence 57,640
a  Martinez C, Cohen AT, Bamber L et al. (2014). Epidemiology of first and recurrent venous thromboembolism: A population-based cohort study in patients without active cancer. Thromb Haemost 14 AD; 112. b

GP registered population 2012: Public Health England – patients registered with GP Practices, by age and sex.

*This figure was derived by using an average of the incidence figures for people aged 80-89 and people aged 90 and over.

 

 

 

 

 

1 https://www.contractsfinder.service.gov.uk/Notice/bbec3a9a-168a-46c5-a71d-990c2a8a8212 2-Breakdown of treatment costs

Appendix 1 Estimated cost impact of providing apixaban per person for the different treatment periods compared with dabigatran etexilate and rivaroxaban

  Length of treatment
  3

monthsa

6

monthsa

12 monthsa Secondary prevention – lifelong treatmentb Per year
Proportion of people having each length of treatment
DVTb42%44%8%8%
PEc3%29%19%50%
Treatment Regimen Estimated drug cost per person (£)e
ApixabanDosage: 10 mg twice a day for 7 days,

<![if !supportLists]>5             <![endif]>mg

twice a day for at least 3

months. After

<![if !supportLists]>6             <![endif]>months

2.5 mg twice a

day

£216£417£818£802
Dabigatran etexilate (without

LMWH)

Dosage

300 mg

(150 mg twice daily).

Age 80+ and people having verapamil dosage is 220 mg

(110 mg twice daily).

£200£402£802£802

 

Dabigatran etexilate (with

9 days of

LMWH)

£307£509£909£802
RivaroxabanDosage:  30 mg per day (15 mg twice daily) for

21 days, 20 mg per day for the remainder of treatment.

£235£428£811£767

 

 

3-Number of patients (from the 2015 document) 

For the remaining population without cancer needing treatment  

after 5 years (102,000), it is estimated that 52% of people with venous

thromboembolism will have newer oral anticoagulants and 48% will have warfarin (costing statement for dabigatran etexilate for the treatment and secondary prevention of deep vein thrombosis and/or pulmonary embolism).

2.8  This equates to an estimated 53,040 people in the eligible population having newer oral anticoagulants and 48,960 having warfarin. The uptake of the newer oral anticoagulants is likely to vary depending on patient choice.

4- Approximate numbers

The new contract award runs for around 3.4 years, so for 53000 patients at around £800 pp

53000x800x3.4 = £144,160,000

The new contract award is said to be

£3,185,000,000

Approximately 21 times the previous figure (£3,027,360,000)?

It’s possible that the 53000 figure is now invalid being 6 years old paper, or maybe the ‘Tory’ government are set to increase the number of recipients moving away from the lower drug cost for warfarin (reducing clinics and saving money that way)  

Given blood clotting may be an underreported covid vaccine side effect, ponder the following example.

Approximate UK population over age of 14

51,000,000 at a estimate of 60 ٪ jabbed (unsure of the real uptake)

60% of 51 million = 30,600,000 (some of whom may be part of the 53000, ignored in this back of cigarette packet calculation)

Multiply the previous 53000 patient figure by 21 to try to match approximate increase in the new tender award sum, you have 1,113,840 patients.

That represents 3.6 ٪of the 30,600,000 estimated jabbed figure above. 

Is there an expectation of 3% or more side effects from covid jabs requiring long term oral anticoagulant treatment?

If so that appears to be orders of magnitude worse than the disease that’s being allegedly treated!

Perhaps there’s other reasons behind this, however it’s worth questioning the numbers. 

 

 

 

 

 

 

[1] https://www.nice.org.uk/guidance/ta341/resources/costingstatementpdf428535325

 

Please share this information!