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Four million people in the United States currently receive warfarin
therapy for medical conditions that require anticoagulation therapy |
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Anticoagulation Therapy |
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Four million people in the United States currently receive warfarin therapy for medical conditions that require anticoagulation therapy and up to nine million people should be receiving treatment. The worldwide market for warfarin therapy has been estimated to exceed 20 million. Warfarin and other "blood-thinning" agents are indicated for a wide variety of conditions including cardiac arrthymias, deep venous thrombosis (clots), and heart valve replacements. In all of these conditions, patients are prone to developing blood clots and therefore are at increased risk for stroke or recurrent venous clots. Chronic administration of warfarin can greatly decrease this risk. In addition, it has been suggested that anticoagulation therapy might be useful in the prevention of second heart attacks in people with established coronary artery disease.
Despite the importance of anticoagulation therapy for these conditions, only a small fraction of patients requiring anticoagulation therapy are currently receiving satisfactory treatment. A key reason for the lack of adequate therapy in the majority of patients who could benefit is that warfarin therapy must be closely monitored for it to be both safe and effective. Patients who receive too little medication remain at risk for blood clots while patients who are overmedicated are at risk for serious internal bleeding. Furthermore, warfarin interacts with many other medications as well as certain foods, so that patients' risks for clotting or bleeding can change from day to day.
The development of home whole blood home prothombin time self-testing devices that use the International Normalized Ratio (INR) has made it possible to solve some of these problems and potentially decrease the need for frequent clinic visits. "Self-testing" refers to patients performing their own INR tests at home and contacting their healthcare provider with the test results for instructions concerning their warfarin dose. Three instruments are currently approved for home self-testing (the Coaguchek® from Roche Diagnositics, the ProTime® from International Technidyne Corporation, and the InRatio® from HemoSense, Inc).
In December 2007 the CMS announced the recommendation to expand coverage of home INR testing. The final decision will be announced in March 2008. By ensuring physician oversight of patient self-management in a cost effective scalable manner, CoagCare will help ensure that more patients have access to this state of the art treatment option. |
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Articles |
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