What is known and objectiveOral anticoagulants (OACs) have been used for decades for the long-term prevention of arterial and venous thromboembolic disease. These include warfarin and the newer direct-acting OACs (DOACs). Data on real-life' prescribing patterns for DOACs are limited. In this commentary, we report the prescribing patterns for OACs in Wales, as a representative country within the UK. CommentA retrospective analysis of anonymized OAC prescribing data in Wales from June 2009 to December 2015. Results reveal that the number of OAC prescription items increased from 4048 to 6526 per 1000 prescribing unit (PU). Average cost increased from 8741 pound to 52931 pound per 1000 PU. The share of warfarin prescribing declined from 100% to 68%, with the a rising share for the DOACs, made up of rivaroxaban (19%), apixaban (9%) and dabigatran (3%) What is new and conclusionAnalysis of real-life data demonstrates that there has been an increase in the overall numbers and costs of OAC prescriptions, with a rising proportion of DOACs to warfarin prescribing.