Hi, @fiddlinchuck. I have two responses to your question about the availability of less expensive anticoagulants, both from my personal experience -- which includes A-fib for several years and a "small stroke" from a blood clot that formed in my heart. From the beginning, my anticoagulant has been Coumadin with the active ingredient Warfarin. My HMO charges me zero for a 90-supply, charging the cost to Medicare. My second response is to the two major inconveniences from Warfarin -- it requires regular lab tests to keep track of the level of coagulation in your blood when on Coumadin and, in addition, it's readily available antidote (Vitamin K solution) may not be on the shelf of the Emergency Room or hospital if you go there for treatment. Another point about Coumadin, I have immediate access to my PhD pharmacologist who manages anticoagulants for my HMO and calls me within hours of every lab test I have to give me the results and to discuss any changes they show. My lab tests, scheduled now every two months, involve about a half-hour away from home each time. Finally, whenever I go to my HMO, any clinic or hospital or emergency room, or an ambulance with EMT staff, I immediately announce my Coumadin treatment and ask whether they have the Vitamin K antidote on hand for immediate use if needed. I would do this with any anticoagulant, because some are not fully supported by the FDA and even those that are sometimes are not on the shelf as I said. I hope my experience will be helpful in your discussions with your doctor. Martin