Implementing Guidelines: The Cost and Clinical Impact of Anticoagulants in the UK XXXX Population.

@entity1 @entity64 @entity548 @entity4151 @entity18988 @entity955
BACKGROUND: Updated treatment guidelines for @entity955 ( @entity955 ) have been released by the National Institute for Health and Care Excellence (NICE) in the UK, and highlight a current shortfall in the prescription of anticoagulants to @entity1 with @entity955 for @entity64 prevention. OBJECTIVE: To design a budget impact model as a planning tool for UK Clinical Commissioning Groups (CCGs) looking to budget for greater use of anticoagulants in the @entity955 population. METHODS: An Excel(  ) model was developed to estimate the five-year impact of gradually treating all eligible @entity1 with @entity955 who are currently not being prescribed anticoagulants, both in terms of the effect on key clinical outcomes ( @entity64 , major @entity548 and mortality) and the associated financial impact. RESULTS: For a population of 251,693 (average CCG size) with an estimated 2626 prevalent @entity1 and an additional 546 incident cases annually, the model estimated that increasing the proportion of the eligible @entity955 @entity1 population receiving anticoagulation by a fraction would require an additional budget of @entity4151 139,961 in Year 1 to treat an additional 314 @entity1 . This would rise to @entity18988 ,004,900 in Year 5 to treat an additional 2242 @entity1 , with all eligible @entity1 treated by this year. The price year was 2014. Over the 5-year timeframe, this could lead to the prevention of 24 @entity64 and 29 deaths, with an increase of 31 major @entity548 . CONCLUSIONS: The clinical benefits of appropriate anticoagulation are widely recognised; however, full implementation can be difficult and costly. Therefore, the development of models can support the planning process by facilitating discussion among stakeholders on how best they can reach full implementation. The model is flexible and can be adapted to suit different payers.
