Last week in The American Journal of Health-System Pharmacy, a team led by University of Southern California researchers reported disruptions in the demand for anticoagulant and antiplatelet medications at US hospitals during the COVID-19 pandemic.
The team used IQVIA National Sales Perspective data to measure the monthly volume of the blood clot-preventing drugs procured by US hospitals from January 2018 to February 2021. The authors noted that these drugs have a role in COVID-19 treatment.
Rebound for most after first few months
Driven by a drop in heparin volume, the total volume of anticoagulants and antiplatelet medications at US hospitals fell 43.4% at the onset of the pandemic in March 2020.
Average monthly volumes declined significantly for parenteral (delivered intravenously) anticoagulants (-106,691,340 extended units [EUs], or numbers of packages multiplied by the number of tablets, capsules, vials, grams, or milliliters), oral anticoagulants (-354,800 EUs), and parenteral antiplatelet drugs (-391,880 EUs).
Relative to before the pandemic, the monthly volume of oral anticoagulants, parenteral anticoagulants, and parenteral antiplatelets rose significantly after the emergence of SARS-CoV-2. Most of the growth was seen in the anticoagulants apixaban, argatroban, enoxaparin, tirofiban, and heparin and the antiplatelet eptifibatide. Apixaban and heparin volumes continued a prepandemic upward pattern, while argatroban and eptifibatide volumes reversed their downward trends.
The researchers said the initial steep decrease in volumes of anticoagulant and antiplatelet drugs may be explained by the drop in healthcare usage in the first months of the pandemic, while subsequent increased demand for anticoagulants may reflect both the growing understanding of the relationship between severe COVID-19 and blood clots and the rise in hospitalizations for acute cardiovascular disease after May 2020.
Need for protocols
"As the treatment paradigm for COVID-19 continues to evolve, the trends in anticoagulant and antiplatelet volume at US hospitals remain of interest as medication shortages persist and institutions brace for ongoing COVID-19 surges due to VOCS [variants of concern]," the authors wrote. "Developing strategies to address fluctuating medication demands during a pandemic is vital to ensuring optimal patient care as each healthcare system braces for future pandemics."
Developing strategies to address fluctuating medication demands during a pandemic is vital.
They add, "Rapid changes in anticoagulant and antiplatelet volume at US hospitals during the COVID-19 pandemic highlight the need for institutional protocols to manage fluctuating medication volume demands.