Edoxaban v Apixaban. Any issues associated with switching?

[WineTaster]

My GP practice is planning to switch me from apixaban to edoxaban, entirely for cost reasons. I have been on apixaban for 2 years+ with absolutely no problems. I am nervous about this change and wondered if anybody has a similar experience, positive or negative?

[Bowler60]

I changed from rivaroxaban to edoxaban over 12 months ago without any problem.

[WineTaster in reply to Bowler60]

Many thanks for the reassurance about edoxaban. Much appreciated!

[Drounding]

I switched from Dabigatran to Edoxoban a couple of years ago with no issues.

[WineTaster]

Thanks for your reassuring reply!

[jimlad2]

I was put on Edoxaban by my GP at age 65 (long AF history) and apart from bleeding gums a couple of hours afterwards each night, I'm not aware of any other problems. However, in the UK there is no officially authorised reversal agent should you develop a serious bleed. Andexanet Alfa is authorised for use with Apixaban/Rivaroxaban/Dabigatran but not Edoxaban (link below). In addition there appear to be more adverse events with it, to such an extent that for the NHS as a whole - the last time I checked the cost benefit analysis rating - it costs less to prescribe Apixaban or Rivaroxaban, despite the higher unit cost. However, it seems that GP practices are incentivised to control their own costs without regard to the global (NHS) picture, which I find astonishing, given that it will probably, in some cases, lead to inferior treatments being administered. I tried to persuade the pharmacist at my last practice to switch me from Edox to one of the others totally without success. The arguments used had no effect whatever. Only cost appeared to be relevant. I don't have a link handy for the cost benefit analysis of drugs by the NHS but it there is such a site out there. gov.uk/drug-safety-update/d...

[WineTaster in reply to jimlad2]

Many thanks for your comprehensive if somewhat worrying reply. I certainly don't fancy having bleeding gums for a couple of hours each night - no such problems with the current apixaban.

Your comments about the lack of licensed reversal agent are also very worrying.

As you say GP practices seem focussed on minimising their own costs regardless of the impact on both total NHS costs and patient wellbeing.

I shall resist the change and see what happens.

Thanks again for your help.

[belindalore in reply to WineTaster]

Yes do everything you can to resist switching. Read my post to jimlad2. It's disgusting profit is put before patients. Ask your Dr why you have to change meds when you are doing well on what you're taking. Fight. Take care and be safe. Wishing you a good outcome. 🙏

[WineTaster in reply to belindalore]

Many thanks for this! I am pleased to say I have very good news in that I spoke to a GP at my practice this afternoon, using a number of arguments put forward by jimlad2 and RoyMacDonald and much to my surprise she agreed fairly quickly that I can remain on apixaban. Many thanks to everybody who replied to my question and especially to those mentioned above. I would strongly recommend that anybody finding themselves in a similar position should use the same arguments. I wish everybody on the forum the best of luck. My experience shows that we should not take such arbitrary and non personal decisions lying down! However, without the forum I am not sure I would have got the same result.

[belindalore in reply to WineTaster]

Yay! Good to hear. Take care.

[belindalore in reply to jimlad2]

The same problem here in the USA with many of these drugs. Because of our insurance companies that foot the cost of these drugs, they get the Drs to prescribe the less costly meds or prescribe generic drugs (claiming generic is the same when they aren't) to keep their profits high. Could care less about the patients. It's disgusting. Seems the same thing many patients face in the UK and other countries. Why should a patient have to change meds when they are doing fine with what they are taking. It's just not right.

[grahamabel]

My surgery switched me from Apixaban to Edoxaban two years ago and this was supported by my cardiologist EP. I’ve not experienced any problems.

[WineTaster in reply to grahamabel]

Thanks for your response and good to know that there are some positive experiences.

[cbsrbpm]

Was switched from Apixaban to Edoxaban when I was started on Dronedarone as Apixaban is somehow contra indicated with Dronedarone. I have had no noticeable problems. Bruise the same with both.

[WineTaster]

Thanks for your reply. I have not had bruising issues with apixaban other than when giving blood for blood tests. Good to hear that you are not aware of other issues.

[RoyMacDonald]

Ask your Dr what happens if you need emergency surgery. His decision to save himself a few pence could have live threatening consequences for you.🤯 I'd change Dr's if he continued to put his cash register above your life. Remind him of the oath he took when he qualified.

All the best.

Roy

[belindalore in reply to RoyMacDonald]

Yes. Seems the Hippocratic oath means zero anymore.Take care.

[WineTaster]

Thanks for this. The strong points you make are much appreciated.