If you check 'CMS Open Payment' website, you will notice that there are physicians that got over $3000 worth of food from big pharma... >$3000 worth of food in one year! Seriously!
If you have 60-70 transactions in your record, that means you pretty much getting meals from big pharma once a week average. I have no problem with that by the way... I went to a couple of these dinners, and they were at nice places. One the reps kept telling me that they will be having other get together next week/month and that I should come.... I said to myself why she is insisting for me to come when I am just a lowly med student? Big pharma marketing campaign is extremely aggressive.
Yeah, the point here is that the manufacturer decided on the dosing schedule. All the research done since FDA approval has been with the FDA approved dosing schedule. That's why CHEST doesn't mention dosing. Same reason it doesn't mention dosing for Plavix - there's only 1 dose.
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But how long is the patient taking the 20 mg PO qDay? I believe the trial states 3 months, 6 months, or 12 months, but why?
But why? If your patient had just had a PE for the first time, WF, 51 years old. No significant medical Hx other than smoker. Upon discharge you would start her on 15mg tablet rivaroxaban PO BID for 21 days, then 20 mg tablet PO daily...but why 3 months, or why 6 months. I've seen a hematologist prescribe 15 mg PO BID for 21 days then 20 mg daily for 6 months then 81 mg ASA for life for a young healthy male who randomly had a DVT/PE due to prothrombin mutation.
That's what everyone uses here. Especially vascular. Plus no INR checks.
