New drug to save 75,000 patients from stroke

Tens of thousands of Scottish heart patients at risk of a stroke, but currently receiving no treatment, could now benefit from the launch of a new drug.

Pradaxa – the first blood-thinning drug to rival warfarin in 50 years – has just been licensed for use in the UK for patients with abnormal heart rhythm, which increases the risk of them suffering a potentially fatal stroke.

The launch means that patients not using warfarin, many because they are unable to tolerate the drug, now have an alternative treatment. But the £2.52 a day cost of the tablets – compared to the price of warfarin, at just £10 a year – will put pressure on NHS finances.

The Scottish Medicines Consortium is set to rule on whether to recommend the drug for use in the NHS next week.

In July The Scotsman warned that experts have already raised fears over how health boards will fund the new drug, with top officials set to meet this month to discuss its introduction.

Pradaxa – also known as dabigatran etexilate – is the first of a number of new drugs in development to be licensed to reduce the risk of stroke patients with atrial fibrillation (AF).

The condition – which affects an estimated 75,000 people in Scotland – causes a fast and irregular heart beat and raises someone’s risk of stroke by five-fold.

While the blood-thinning drug warfarin helps reduce this risk, it requires frequent monitoring and can also be affected by some foods and other drugs.This means it is estimated that almost half of patients who should be on blood-thinning treatment are not receiving it.

Doctors now hope these patients may be able to benefit from Pradaxa and cut the numbers suffering from a stroke.

Trials suggest a bigger reduction in the risk of stroke with Pradaxa compared to warfarin and lower risks of complications such as major bleeds.

Dr Alan Begg, a GP in Montrose with a special interest in cardiology, said he hoped that they would be able to prioritise the treatment for patients currently not receiving blood-thinning therapy.

“It is not going to happen overnight that everybody who is on warfarin is going to be changed. It would be unrealistic for practitioners to do that,” he said.

“But I think in anybody who is newly diagnosed with AF and deemed to be at high risk from stroke then we will have to assess whether they will benefit from the drug.”

Jon Barrick, chief executive of The Stroke Association, said: “Warfarin is a highly effective treatment for stroke prevention, but it is often under-used by GPs and health professionals, one of the reasons being because patients have to have regular blood tests to monitor its effects.

“In some recent research conducted for The Stroke Association only 40 per cent of GPs said they would treat AF patients with warfarin. For a long time there has been a need for a useful alternative treatment to warfarin, which can be used when warfarin is not appropriate.”

Trudie Lobban, of the Atrial Fibrillation Association, added: “Our members live in fear of suffering a disabling or fatal stroke and have waited years for an alternative to current treatment.”