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RACGP Submission to the Department of Health and Ageing -Review of Anticoagulation Therapies in Atrial Fibrillation

21 February 2012

The RACGP supports safe and effective prescribing, and wise use of medicines in Australian health care. We acknowledge the worthy intention of this review to appraise Anticoagulation Therapies in Atrial Fibrillation. The College felt this issue warranted a response because of concerns about medication safety in primary care.

The RACGP believes General Practitioners (GPs) have the training and skills to prescribe these medications. General Practitioners are the largest group prescribing, monitoring and evaluating anticoagulants in Australia.

The review is timely given the introduction of new anticoagulant options. The RACGP believes this has been associated with significant marketing processes which have the capacity to reduce both quality prescribing and patient safety.

The introduction of these therapies also highlights an ongoing concern for the RACGP; the migration of moderate risk medications (serious adverse event rate 2.7%) into primary care in the absence of suitable infrastructure to monitor drug efficacy, drug interaction, and post-marketing surveillance in general.

The RACGP believes that the current quality of “time in therapeutic range” for warfarin therapy in Australian primary care may negate the perceived benefits of the new drug.

This submission will highlight the need for drug safety infrastructure in General Practice, as well as details our concerns regarding oral anticoagulant therapies from a General Practice perspective.