New Drugs to Prevent Strokes

What’s causing this ripple is the emergence of new anticoagulant drugs, or blood thinners. Dabigatran (brand name Pradaxa) has already won Food and Drug Administration approval; rivaroxaban (Xarelto) has been endorsed by an F.D.A. advisory panel and awaits a final decision in November. A third drug, apixaban (Eliquis), exceeded investigators’ expectations in global clinical trials, according to findings just reported in The New England Journal of Medicine, and the manufacturer will seek F.D.A. approval by year’s end.

But what caused excitement at the recent meeting of the European Society of Cardiology in Paris was that apixaban, a twice-daily pill, went prevented 21 percent more strokes than warfarin, the standasrd drug currently prescribed, over the 1.8 years of the study and reduced deaths from any cause by 11 percent, in addition to reducing major bleeding incidents by nearly a third.

The less-than-cheerful news is how much more the new meds cost than warfarin. Coumadin retails for about $1.50 a day, depending on dose. The generic goes for less than $10 a month at some big chains. By contrast, apixaban is expected to sell for $7 a day, a stiff price for patients on fixed incomes, even if they have Medicare Part D.

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