Direct oral anticoagulants (DOACs) are widely used pharmaceutical products which represent a significant cost to the healthcare system. In 2021, National Health Service England (NHSE) spent around £690 million ($840 million) on DOACs in primary care1. Here, we have collated secondary research and insights from UK payers to describe how COVID-19 driven changes resulted in a national therapeutic area tender and how this tender has expanded into a novel procurement framework. The framework has had significant implications for DOACs, driving down prices and influencing payer management of the therapeutic class. Importantly, manufacturers should be aware that given the payer perceived success of this procurement framework, NHSE may implement a similar framework across analogous therapeutic classes to drive cost savings.
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