NOACs Added to WHO’s Essential Medicines List: Recommendations for Future Policy Actions
Mariachiara Di Cesare,
Jordan D. Jarvis,
Oana Scarlatescu,
Xinyi Leng,
Ezequiel J. Zaidel,
Esteban Burrone,
Jean-Luc Eiselé,
Dorairaj Prabhakaran,
Karen Sliwa
Affiliations
Mariachiara Di Cesare
Middlesex University, London
Jordan D. Jarvis
London School of Hygiene and Tropical Medicine, London
Oana Scarlatescu
World Heart Federation, Geneva
Xinyi Leng
The Chinese University of Hong Kong, Shatin
Ezequiel J. Zaidel
Cardiology Department, Sanatorio Güemes, and the University of Buenos Aires, Buenos Aires
Esteban Burrone
Medicines Patent Pool, Geneva
Jean-Luc Eiselé
World Heart Federation, Geneva
Dorairaj Prabhakaran
London School of Hygiene and Tropical Medicine, London, GB; World Heart Federation, Geneva, CH; Public Health Foundation of India, Gurgaon
Karen Sliwa
World Heart Federation, Geneva, CH; Hatter Institute for Cardiovascular Research in Africa, University of Cape Town; CHI, Faculty of Health Sciences, University of Cape Town
The introduction of non-vitamin K antagonists oral anticoagulants, a class of medicines which includes dabigatran, apixaban, edoxaban and rivaroxaban, has resulted in improvements in the safety and efficacy of non valvular atrial fibrillation treatment for stroke prevention, with significant reductions in stroke, intracranial haemorrhage, and mortality. For these reasons, a team of World Heart Federation Emerging Leaders led efforts to add non-vitamin K antagonists oral anticoagulants to the World Health Organization’s Model List of Essential Medicines in 2019. Following the inclusion of this class of medicines in the Essential Medicines List, this editorial proposes several recommendations to improve the accessibility, affordability and acceptability of non-vitamin K oral anticoagulants, especially in low- and middle-income settings, in order to successfully manage non-valvular atrial fibrillation and to lower the risk of stroke.
