Question to the Department of Health and Social Care:

To ask Her Majesty's Government what estimate they have made of the uptake of innovative anti-coagulant medicines in the management of venous thromboembolism in the National Health Service.

Decisions on the prescribing of medicines are a matter for clinicians in discussion with their patients.

Dabigatran (Pradaxa), apixaban (Eliquis) and rivaroxaban (Xarelto) are recommended in National Institute for Health and Care Excellence (NICE) technology appraisal guidance for use in reducing the risk of venous thromboembolism (VTE)after hip or knee replacement surgery. Rivaroxaban is also recommended as a treatment option for adults with deep vein thrombosis and in the prevention of recurrent deep vein thrombosis and pulmonary embolism. National Health Service commissioners are legally required by regulations to fund those treatments recommended by NICE in its technology appraisal guidance.

NHS England has advised that it is working with the Health & Social Care Information Centre as part of the National VTE Prevention Programme to analyse the uptake of medicines in this area.

The Health and Social Care Information Centre's report on the Use of NICE appraised medicines in the NHS in England 2012, published on 21 January 2014, includes information on the usage of dabigatran etexilate, apixaban and rivaroxaban for prevention of venous thromboembolism after hip or knee replacement surgery in secondary care.

The report showed an increase in mean usage over time during 2010-2012 and an increase in the total use of the drugs over time, which had accelerated in 2012. The report is available at:

www.hscic.gov.uk/catalogue/PUB13413/use-nice-app-med-nhs-exp-stat-eng-12-rep.pdf