A retrospective study linked Scottish inpatient, outpatient, prescribing and care-home records for 47,427 people with incident atrial fibrillation between 2010 and 2016, following them for five years and grouping them by oral anticoagulant exposure. Continuous therapy was associated with the lowest annual cost per patient (GBP 7,288), while never starting (GBP 22,751) and cessation (GBP 22,157) carried the highest, driven by inpatient and long-term care use. Costs were GBP 20,562 in the most deprived group against GBP 12,734 in the least.
Why it is interesting: A monetary gradient on anticoagulant persistence and on deprivation in one national linked dataset, with groups defined after the fact so that confounding by frailty is hard to exclude.