Utilization patterns, cost analysis, and monitoring burden of warfarin and rivaroxaban in Oman: a retrospective study (2019–2024)

Background: Warfarin and Rivaroxaban are common anticoagulants with distinct profiles. Warfarin, a vitamin K an¬tagonist, requires frequent international normalized ratio (INR) monitoring and dose adjustments. Rivaroxaban, a di¬rect oral anticoagulant (DOAC), allows fixed dosing with minimal monitoring but is more expensive. Aim: To compare prescribing trends, patient demographics, and cost implications of warfarin and rivaroxaban in Oman from January 2019 to May 2024. Methodology: Prescription data were reviewed for drug utilization, number of patients, prescrip¬tions, tablets dispensed, and related costs. INR test counts for warfarin were also analyzed. Costs were reported in Omani Rial (R.O). Results: Warfarin was prescribed to 238 patients, totaling 6,813 prescriptions and 292,812 tablets. Rivaroxaban was prescribed to 28 patients, with 445 prescriptions and 11,491 tablets. Total cost: warfarin (12,143.28 R.O), rivaroxaban (7,554.38 R.O). Switching all warfarin users to rivaroxaban would cost 30,184.56 R.O. INR moni¬toring for warfarin users involved 1,626 tests. Conclusion: Warfarin remains widely used in Oman due to lower cost, despite rivaroxaban’s ease of use. High expense limits rivaroxaban adoption. Future studies should explore long-term outcomes and cost-effectiveness of broader DOAC use.