Boost warfarin prescriptions to cut NHS costs by £124m

Ensuring all eligible AF patients take warfarin could prevent 11,600 strokes and save the NHS £124m a year, according to NHS experts.

Warfarin: wider use could cut NHS costs (Photo: SPL)
Warfarin: wider use could cut NHS costs (Photo: SPL)

NHS Improving Quality, an organisation set up by NHS England to drive up care standards, urged GPs to use the freely-accessible GRASP-AF tool to help them assess whether patients should be receiving treatment for the condition and to check patient care plans.

It used data from the GRASP-AF audit tool to estimate the England-wide prevalence of AF and prescribing patterns.

The resultant report reveals that only half (54%) of those eligible for anticoagulants, as according to the latest NICE guidelines, are currently receiving treatment.

NICE outlines that patients meet the prescribing requirements if they have a CHA2DS2-VASc score of two or more. But with only 54% taking treatment, ‘it is likely that there are substantial numbers of people with AF who would benefit from anticoagulation therapy but are not receiving it’, warned NHS Improving Quality.

It concluded that a further 16,000 strokes a year – including 3,200 that would have been fatal – could be averted if all patients with AF were prescribed warfarin.


The group calculated that, over a lifetime, 0.3 strokes would be averted and 0.79 QALYs would be gained per person with AF should they receive warfarin treatment. This would create net savings of £2,400 for the NHS per patient and £124m a year.

Hilary Walker, head of the Living Longer Lives programme at NHS Improving Quality, said: ‘Data from the GRASP-AF audit tool shows us that currently not everyone is being managed as well as they should be.

‘This is putting patients’ lives at risk and costing the NHS and social care millions of pounds every year. GP practices can use the GRASP-AF tool for free to quickly identify patients who have, or might have AF, and check their management plan.

‘We encourage all GP practices not currently using GRASP-AF to download the tool and start to audit their care of people with AF.’

The NHS estimates that more than 900,000 people in England have AF, equivalent to almost 2% of the population. The condition is associated with an increased risk of stroke, heart failure and premature mortality.

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