Patients who are well controlled on warfarin derive the least benefit from a
change to dabigatran.
Creatinine clearance < 30ml/min.
Documented history of PUD, GI bleeds (or risk of), or significant GERD.
Taking rifampin
Patient concerns about higher drug costs. Most members will pay a higher
Brand co-pay for dabigatran and a lower generic co-pay for warfarin.
Average monthly costs are about $200 with dabigatran and $10 with
warfarin.