Availability of medical and endovascular therapies for venous thromboembolism: a global survey for World Thrombosis Day.

World Thrombosis Day anticoagulation survey treatment venous thromboembolism

Journal

Journal of thrombosis and haemostasis : JTH

ISSN: 1538-7836

Titre abrégé: J Thromb Haemost

Pays: England

ID NLM: 101170508

Informations de publication

Date de publication:
12 Oct 2023

Historique:

received: 10 09 2023

revised: 01 10 2023

accepted: 03 10 2023

pubmed: 15 10 2023

medline: 15 10 2023

entrez: 14 10 2023

Statut: aheadofprint

Résumé

Data on availability, affordability, and accessibility is key for the planning of global strategies to reduce the burden of venous thromboembolism (VTE). A survey was conducted for the 10th anniversary of World Thrombosis Day to assess the availability of VTE therapies worldwide and challenges in uniform implementation. We gathered information on the approval status, availability, utilization, occurrence of shortages, and spread of medical and interventional therapies for VTE. Furthermore, we collected information by accessing or contacting national or continental medicines agencies, manufacturers or distributors, and online drug repositories. We obtained data from a total of 69 countries: 33 countries in Europe, 19 in Asia, 7 in the Americas, 9 in Africa, and 1 in Oceania. Unfractionated heparin, low-molecular-weight heparin, and vitamin K antagonists were available in almost all countries, but shortages were recorded in 13%, 19%, and 15% of them, respectively. Direct oral anticoagulants were available in approximately three-quarters of the surveyed countries. At least one parenteral medication for heparin-induced thrombocytopenia was available in 57% of countries and a shortage was reported in 9% of these. Shortage of thrombolytics was recorded in 50% of countries. Overall, at least one type of catheter-directed therapy system was approved for use in 77% of countries and available in 23% of surveyed institutions. Our findings revealed notable geographic disparities in the worldwide availability of VTE therapies, the access to which appeared to be limited by economic and geopolitical factors. We anticipate that this comprehensive information will play a pivotal role in highlighting the shortcomings of VTE therapies and the lack of homogeneous availability globally.

Sections du résumé

BACKGROUND BACKGROUND

Data on availability, affordability, and accessibility is key for the planning of global strategies to reduce the burden of venous thromboembolism (VTE).

OBJECTIVES OBJECTIVE

A survey was conducted for the 10th anniversary of World Thrombosis Day to assess the availability of VTE therapies worldwide and challenges in uniform implementation.

METHODS METHODS

We gathered information on the approval status, availability, utilization, occurrence of shortages, and spread of medical and interventional therapies for VTE. Furthermore, we collected information by accessing or contacting national or continental medicines agencies, manufacturers or distributors, and online drug repositories.

RESULTS RESULTS

We obtained data from a total of 69 countries: 33 countries in Europe, 19 in Asia, 7 in the Americas, 9 in Africa, and 1 in Oceania. Unfractionated heparin, low-molecular-weight heparin, and vitamin K antagonists were available in almost all countries, but shortages were recorded in 13%, 19%, and 15% of them, respectively. Direct oral anticoagulants were available in approximately three-quarters of the surveyed countries. At least one parenteral medication for heparin-induced thrombocytopenia was available in 57% of countries and a shortage was reported in 9% of these. Shortage of thrombolytics was recorded in 50% of countries. Overall, at least one type of catheter-directed therapy system was approved for use in 77% of countries and available in 23% of surveyed institutions. Our findings revealed notable geographic disparities in the worldwide availability of VTE therapies, the access to which appeared to be limited by economic and geopolitical factors.

CONCLUSION CONCLUSIONS

We anticipate that this comprehensive information will play a pivotal role in highlighting the shortcomings of VTE therapies and the lack of homogeneous availability globally.

Identifiants

DOI: 10.1016/j.jtha.2023.10.002 PMID: 37838241

pubmed: 37838241

pii: S1538-7836(23)00765-1

doi: 10.1016/j.jtha.2023.10.002

pii:

doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

Investigateurs

Sara A Malerba (SA)

Riccardo M Fumagalli (RM)

Cihan Ay (C)

Gabriela Cesarman-Maus (G)

Erich V De Paula (EV)

Mert Dumantepe (M)

Maria Cecilia Guillermo Esposito (MCG)

Lukas Hobohm (L)

Parham Sadeghipour (P)

Charles M Samama (CM)

Maria Teresa Sartori (MT)

Lana A Castellucci (LA)

Stefano Barco (S)

Jean M Connors (JM)

Lai Heng Lee (LH)

Eriko Morishita (E)

Helen Okoye (H)

Todd Robertson (T)

Gordon McPherson (G)

Informations de copyright

Déclaration de conflit d'intérêts

Declaration of competing interests C.A. received honoraria for lectures and participation in advisory boards from Bayer, BMS/Pfizer, Daiichi Sankyo, and Sanofi. L.A.C. research institution has received honoraria from Bayer, BMS-Pfizer Alliance, The Academy for Continued Advancement in Healthcare Education, Amag Pharmaceutical, LEO Pharma, Sanofi, Valeo Pharma, and Servier. L.A.C. holds a Tier 2 research Chair in Thrombosis and Anticoagulation Safety from the University of Ottawa. S.B. received institutional grants from Sanofi, Concept Medical, Bayer, Medtronic, Boston Scientific, Bard, Novartis, and Daiichi Sankyo and honoraria for advisory boards or lectures from Boston Scientific, Penumbra, Viatris, Bayer, Sanofi. S.A.M., R.M.F., G.C.M., E.V.D.P., M.D., M.C.G.E., L.H., P.S., C.M.S., and M.T.S. report no conflicts of interest.