• Overall summary(challenges/gaining point):
HUSM
• Focus department:
• 1.Medical: Dr Mohd Azlan
HOD
• 2.Ortho: Prof Dr Amran HOD
• 3.Haemato: Dr Mohd Azlan
1. Medical Dept supported the use of Arixtra depending on
indication.
The specialists are using Arixtra as well.
2.Ortho HOD support Arixtra due to convenience
synthetic product & good result less weeping wound
compared to enox
3.Haemato Consultants are supporting Arixtra however require
more work especially desimanating the VTE thromboprophylaxis
& treatment messages
. Arixtra 2.5mg sales contribution by department (by
percentage):
1.[70%]Medical
2.[20%]Ortho
3.[10%]Haemato
• Arixtra 7.5mg sales contribution by department (by
percentage):
1.[80%]Medical
2.[20%]Emergency
 Medical Department
HOD (Dr Azlan), view on Arixta 2.5mg
1.Preferably to use Arixtra for all patient needed to use anticoagulant unless contraindicated or ckd pts.
2. Synthetic & no animal derivative

Consultant/Specialist view Medical Officer View

• Total consultant/specialist: 30
• Arixtra supporter: 70% depending on indication.
Reason: readily available, synthetic origin, ample
studies, proven & familiarity.
• Neutral: 30%, needed more convincing with regular
presence.
• Total Medical Officer: 80
• Arixtra supporter: 70%, reason
• Neutral: 30%,reason Less clinical experience esp with
parenteral anti coagulant
• clexane (enoxa) supporter: 30% for ckd pts

• clexane (enoxa): 30%, for ckd pts < CrCl20 • Xarelto (rivaroxaban) 25%, oral & compliance

• xarelto (rivaroxaban): 25%, oral & compliance

 PRIORITISED SWOT: Analysis & Key Implications-
ARIXTRASTRENGTHS
in VTE WEAKNESSES
1. Established product, simple to use, effective & proven 1. Not indicated for ckd pts with CrCl <20mL/min for 2.5mg &
safety clinically. <30mL/min for 7.5mg
2. Ample clinical data's. 2. Not indicated for pregnancy
3. Synthetic & no animal derivative 3. No reversal agent or specific antidote in the event of
4. OD dose. overdose
4. Limited coverage due to many centres in Kelantan
5. Lack of mass disseminating key messages for the disease.

OPPORTUNITIES
1. VTE remains underdiagnosed & medical
thromboprophylaxis continues to be dramatically
underused.
2. Easy transition to orals like warfarin & doac
THREATS
1. Competitors –clexane & Doac.. more established &
indications & oral compliance
2. Dept budget for anticoagulant.

KEY IMPLICATIONS
1. More time needed to allocated to the centre especially for CME’s will help to disseminate the key messages
2. Continue to remind Drs especially those neutral on Arixtra advantages vs clexane on safety profile & to use Arixtra during
acute phase
3. Keep highlighting that VTE remains underdiagnosed & med thromboprophalaxis should be considered for high risk pts.
Kuantan
Medical
• Overall summary(challenges/gaining point):
1.Medical consultant support Arixtra due to familiarity
Centre and synthetic product
2.Ortho consultant is neutral, at time using for high risk pts,
• Focus department: require more convincing for
surgical thromboprophylaxis esp for arthroplasty cases
• 1.Medical • Arixtra 2.5mg sales contribution by department (by
• 2.Ortho percentage):
1.[90%] Medical
2.[10%] Ortho
• Arixtra 7.5mg sales contribution by department (by
percentage):
1.[100%] Medical
 Medical consultant
Medical consultant view on Arixta 2.5mg:
1.Preferably Arixtra for all patient unless contraindicated, ckd pts or those pt require short half life anticoagulant.

Consultant/Specialist view Medical Officer View

• Total consultant/specialist: 5
• Arixtra supporter: 3, synthetic, simple & effective
• Neutral: 2, not routinely given for medical
thromboprophalaxis unless high risk pts.
• xarelto (rivaroxaban)5. Oral & compliance
• clexane (enox) 5, for ckd pts
• Total medical officer: 6
• Arixtra supporter: 6,synthetic, simple & effective
• Neutral:
• Clexane, depending on pts condition whether needed to
use long or short acting anticoagulant.
 PRIORITISED SWOT:Analysis & Key Implications-
ARIXTRA in VTE
STRENGTHS WEAKNESSES
1. Established product, simple to use, effective & proven 1. Not indicated for ckd pts.
safety clinically 2. Not indicated for pregnancy
2. Ample clinical data’s. 3. No specific antidote or reversal especially when overdose
3. Synthetic & no animal derivative 4. Limited coverage as spending only 2 days in a month
4. OD dose
OPPORTUNITIES THREATS
1. VTE remains underdiagnosed & medical 1. Competitors- clexane & doac
thromboprophylaxis continues to be dramatically
underused.
2. Easy transition to orals like warfarin & doac
KEY IMPLICATIONS
1. More time needed to allocated to the centre especially for CME’s will help to disseminate the key messages
2. Continue to remind Drs especially the neutral on Arixtra advantages vs clexane on safety profile & to use Arixtra during
acute phase
3. Keep highlighting that VTE remains underdiagnosed & med thromboprophalaxis should be considered for high risk pts.