Brain stroke

Thousands spared strokes thanks to new NHS drug agreements

More than 20,000 strokes and 5,000 deaths could be averted after NHS England struck new agreements to expand life-saving blood thinning drugs, Chief Executive Amanda Pritchard has announced.

The NHS will now dramatically scale up the use of direct oral anticoagulants (DOACs), with as many as 610,000 more patients set to benefit over the next three years.

The drugs prevent strokes by treating and preventing blood clots in patients with atrial fibrillation (AF), a condition that causes an irregular and often abnormally fast heart rate.

This new framework agreement means their use will be expanded in line with the NHS Long Term Plan commitment to tackle strokes and other cardiovascular disease.

Speaking at NHS Providers conference, NHS Chief Executive, Amanda Pritchard said:

“The agreements struck by NHS England will save thousands of lives and prevent many more people suffering the debilitating effects of strokes by making this treatment available to hundreds of thousands more patients.

“The Health Service now has a proven track record of striking deals with manufacturers to ensure patients in England get cutting-edge care at a price which offers best value for taxpayers.

“As we continue to emerge from the pandemic, tackle the backlogs of care which have been created and maintain momentum in the NHS Covid vaccination programme, we are also determined to keep delivering more innovation and greater efficiency in patients’ care.”

As well as expanding the use of direct oral anticoagulants, NHSX is also using cutting-edge technology to diagnose those with potentially fatal heart conditions, Ms Pritchard told the conference.

In a pilot, more than 5,000 people have been given wearable patches that use AI technology to analyse their heart rate, diagnosing potentially fatal conditions.

The technology provides clinicians with all the information they need to make a quick diagnosis and start treatment without the need for patients to undergo lots of tests and hospital visits.

The agreement on DOACs comes after NICE recommended the drugs as being more effective for the prevention of AF-related stroke than other anticoagulants.

NHS England then initiated a national procurement deal on DOACs, with the aim of making expanding access more affordable and saving money for both the Health Service and the taxpayer from the reduction in strokes.

The previous standard of anticoagulation treatment involved people needing to regularly attend their GP surgery or hospital for frequent monitoring, however, treatment with a DOAC often only requires people to attend an annual review of their medicines.

NHS England’s new agreement will make DOACs more affordable, allowing the local NHS to provide them to 610,000 more patients.

Uptake of DOAC treatment at this level will help to prevent an estimated 21,700 stokes and save the lives of 5,400 patients from a fatal outcome over the next three years.

Up to £40m worth of investment will also be made in ‘Detect, Protect and Perfect’ pathway initiatives, which will also help identify people with AF and move them onto effective and appropriate treatment.

NHS England’s National Specialty Adviser for Cardiovascular Disease Prevention, Helen Williams said:

“The new agreement for these drugs is good news for the estimated 1.5 million people in England with atrial fibrillation, which is an irregular heart rhythm that causes one in five strokes.

“Not only is stroke one of the biggest killers in our country, but it leads to life-changing and often devastating long-term harm for many others.

“So, by ensuring these drugs are made available for all people with AF who are at risk of stroke, the NHS will not only prevent serious harm to the people affected but avoid the need for aftercare which puts additional pressure on the Health Service.

“Tackling heart disease and stroke is a top priority in the NHS Long Term Plan, which will save thousands of lives by better diagnosis and treatment for people with killer conditions.”

There are four different DOACs licensed to treat AF, which have all been recommended by NICE, while warfarin will still be used for some patients where appropriate.

A patient’s clinician will determine the most effective and appropriate treatment for a patient based on their clinical needs.

This commercial agreement for DOACs, that will go live from 1 January 2022, builds on NHS England’s approach to Hepatitis C elimination.

This saw a unique agreement with the pharmaceutical industry to support wider use of Hepatitis C treatments by targeting patients not already receiving treatment.

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NHE May/June 2024

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