Harvard Heart Letter

Heart Beat: Warfarin home monitoring program expanded

Heart Beat

Warfarin home monitoring program expanded

If you take warfarin (Coumadin) because you have atrial fibrillation or have had a blood clot in a leg or lung, Medicare will pay for you to check your blood clotting time at home. This change, announced in March 2008, may save you time and make taking warfarin safer.

All people who take warfarin must routinely check their INR, a measure of how long it takes blood to clot. This simple blood test shows whether your warfarin dose is too low (which could lead to a blood clot), too high (which could lead to bleeding in the brain or elsewhere), or just right.

Home INR monitors have been on the market since the 1990s, but they cost more than $1,000. In 2002, the Centers for Medicare and Medicaid Services agreed to pay for home INR testing for people with artificial heart valves. It has since vastly expanded the pool of people who can take advantage of this service.

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