Increasing Availability of the International Normalized Ratio Control in Russia

Abstract

Background: Warfarin is still, in some cases, the only medication to prevent thromboembolic complications. Warfarin intake imposes regular INR monitoring, which can be performed domiciliary. Currently, in the Russian market, there are two models of automatic portable blood coagulometers: CoaguChek XS (Germany) and qLabs ElectroMeter (China). The main problem of portable coagulometers is their high cost and high cost of operation, which the majority of patients cannot afford. To explore the demand for development of a Russian coagulometer with a more affordable price, a questionnaire survey was carried out among the patients who needed this device. Methods and Results: We surveyed 70 patients taking Warfarin, with 5 years duration paroxysmal, persistent/or stable atrial fibrillation of nonvalvular etiology, having >2 CHADS-VASc score for thrombembolia risk assessment and <3 HAS-BLED score for hemorrhage risk assessment. According to the survey results, 7 (10%) patients had portable coagulometers, including 3 persons with CoaguChek XS and 4 persons with Micropoint qLabs ElectroMeter. Among these patients, there were 4 persons who continued regular INR monitoring domiciliary, while 3 patients had financial difficulties in getting testing strips. At the same time, 14 (20%) patients were not aware of the possibility of domiciliary INR monitoring. Patients who received regular INR monitoring domiciliary with a portable coagulometer, or at their local polyclinics, had neither ischemic strokes nor hemorrhages within a period of five years. Conclusion: It is critical to develop and manufacture a domestic equivalent of a portable coagulometer and testing strips for household use at a more affordable price.