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

J Thromb Haemost. 2024 Jan;22(1):255-262. doi: 10.1016/j.jtha.2023.10.002. Epub 2023 Oct 12.

Abstract

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

Objectives: 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: 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: 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: 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.

Keywords: World Thrombosis Day; anticoagulation; survey; treatment; venous thromboembolism.

MeSH terms

  • Anticoagulants / adverse effects
  • Fibrinolytic Agents / adverse effects
  • Heparin / adverse effects
  • Heparin, Low-Molecular-Weight / therapeutic use
  • Humans
  • Thrombosis* / drug therapy
  • Venous Thromboembolism* / diagnosis
  • Venous Thromboembolism* / drug therapy
  • Venous Thromboembolism* / epidemiology

Substances

  • Heparin
  • Anticoagulants
  • Heparin, Low-Molecular-Weight
  • Fibrinolytic Agents