Chronic heart failure patients are subject to high rates of mortality and morbidity and frequent readmissions to the hospital mean that chronic heart failure also represents a significant healthcare burden. The Current Treatment Chronic Heart Failure (US) report offers a snapshot of how U.S. cardiologists prescribe currently available therapies, provides insight into the factors driving such prescribing habits, as well as anticipated future changes in prescribing practices.

Table of contents

  • Heart Failure - Current Treatment - Detailed, Expanded Analysis Chronic Heart Failure (US)
    • Physician Prescribing Practices
      • Key Findings
      • Patient Characteristics
        • Patient Characteristics Do Not Differ Significantly Between HFrEF and HFpEF
        • Percentage of Newly Diagnosed Chronic Heart Failure Patients by NYHA Class
        • Percentage of Chronic Heart Failure Patients with Reduced or Preserved Ejection Fraction by NYHA Class
        • Percentage of Chronic Heart Failure Patients with Reduced or Preserved Ejection Fraction Requiring Hospitalization for Acute Decompensated Heart Failure
        • Prevalence of Comorbidities Among Chronic Heart Failure Patients with Reduced or Preserved Ejection Fraction
        • Gender Distribution Among Patients Diagnosed with Chronic Heart Failure (RWD)
        • Race Distribution Among Patients Diagnosed with Chronic Heart Failure (RWD)
        • Age Distribution Among Patients Diagnosed with Chronic Heart Failure (RWD)
        • Body Mass Index Distribution Among Patients Diagnosed with Chronic Heart Failure (RWD)
      • Treatment Practices
        • Treatment Approach in CHF Is Shaped by Disease Severity
        • Share of Preference for the Classification Systems Used in the Diagnosis of Chronic Heart Failure Patients
        • Treatment Is Initiated Soon After CHF Diagnosis
        • Time to Treatment Initiation After Chronic Heart Failure Diagnosis by NYHA Class
        • Treatment Rates Are High Among CHF Patients
        • Percentages of Drug-Treated Chronic Heart Failure Patients with Reduced or Preserved Ejection Fraction
        • Beta Blockers, ACE Inhibitors, and Loop Diuretics Dominate CHF Treatment
        • Drugs/Drug Classes Prescribed to Chronic Heart Failure Patients by NYHA Class
        • Drugs/Drug Classes Prescribed to Chronic Heart Failure Patients with Reduced or Preserved Ejection Fraction
        • Beta Blocker Drug Class Share Among Chronic Heart Failure Patients with Preserved or Reduced Ejection Fraction
        • ACE Inhibitor Drug Class Share Among Chronic Heart Failure Patients with Preserved or Reduced Ejection Fraction
        • AIIRA/ARB Drug Class Share Among Chronic Heart Failure Patients with Preserved or Reduced Ejection Fraction
        • Mineralocorticoid Receptor Antagonist Drug Class Share Among Chronic Heart Failure Patients with Preserved or Reduced Ejection Fraction
        • Oral Loop Diuretic Drug Class Share Among Chronic Heart Failure Patients with Preserved or Reduced Ejection Fraction
        • Oral Thiazide Diuretic Drug Class Share Among Chronic Heart Failure Patients with Preserved or Reduced Ejection Fraction: Single Therapy vs. Fixed-Dose Combination
        • Oral Nitrate Drug Class Share Among Chronic Heart Failure Patients with Preserved or Reduced Ejection Fraction
        • Oral Calcium-Channel Blocker Drug Class Share Among Chronic Heart Failure Patients with Preserved Ejection Fraction
        • Patient Share by Product Among Drug-Treated Patients Diagnosed with Chronic Heart Failure (RWD)
        • Once Initiated, CHF Treatment Is Lifelong
        • Lifestyle Therapy Plays a Role in the Management of CHF
        • Percentage of Chronic Heart Failure Patients with Preserved or Reduced Ejection Fraction with Implanted Cardiac Assist Devices
        • Percentage of Chronic Heart Failure Patients on the Heart Transplant Waiting List
        • Combination Therapy Is Used Across All Lines of Treatment
        • Patients with More Severe Disease Are More Likely to Be on a Later Line of Treatment
        • Percentages of Chronic Heart Failure Patients on Different Lines of Therapy by NYHA Class
        • Percentages of Chronic Heart Failure Patients Prescribed Monotherapy or Combination Therapies by Line of Therapy
        • Progression Occurs Most Commonly Through Addition
        • Percentages of Chronic Heart Failure Patients Progressing from One Line of Therapy to the Next
        • Cost Does Not Strongly Influence the Choice of Treatment in CHF
        • Drugs/Drug Classes Typically Prescribed in Each Line of Chronic Heart Failure Treatment
        • Theoretical Sequence of Use of Drugs/Drug Classes for Chronic Heart Failure in the Absence of Cost and Reimbursement Constraints
        • Product Patient Share by Line of Therapy (RWD)
        • Treatment Duration Is Similar Among Standard-of-Care Therapies
        • Drug Progression Rates from First Line of Therapy Among Drug-Treated Patients Diagnosed with Chronic Heart Failure (RWD)
        • Drug Progression Rates from Second Line of Therapy Among Drug-Treated Patients Diagnosed with Chronic Heart Failure (RWD)
        • Combination Therapy Is Common in CHF
        • Monotherapy vs. Combination Therapy Use by First Line of Therapy Among Drug-Treated Patients Diagnosed with Chronic Heart Failure (RWD)
        • Monotherapy vs. Combination Therapy Use by Second Line of Therapy Among Drug-Treated Patients Diagnosed with Chronic Heart Failure (RWD)
        • Monotherapy vs. Combination Therapy Use by Third Line of Therapy Among Drug-Treated Patients Diagnosed with Chronic Heart Failure (RWD)
        • Combination Therapies by First Line of Therapy Among Drug-Treated Patients Diagnosed with Chronic Heart Failure (RWD)
        • Combination Therapies by Second Line of Therapy Among Drug-Treated Patients Diagnosed with Chronic Heart Failure (RWD)
        • Combination Therapies by Third Line of Therapy Among Drug-Treated Patients Diagnosed with Chronic Heart Failure (RWD)
      • Persistency and Compliance
        • CHF Patients Generally Follow Management Recommendations
        • Percentage of Chronic Heart Failure Patients Who Discontinued Treatment Within the First Year
        • Average Time Between Initiation and Premature Discontinuation of Chronic Heart Failure Treatment by Drug/Drug Class
        • Rates of Compliance with Pharmacotherapy Among Patients with Chronic Heart Failure by Drug Class
      • Sequencing of Treatment
        • Insufficient Efficacy Is the Main Reason for Treatment Change in CHF
        • Reasons for Switching to or Adding a New Drug Class for the Treatment of Chronic Heart Failure
        • Rate of Dose Change, Addition of, or Switching to a New Drug Among Patients Whose Symptoms Are Not Controlled on an Oral Beta Blocker
        • Rate of Dose Change, Addition of, or Switching to a New Drug Among Patients Whose Symptoms Are Not Controlled on an Oral Loop Diuretic
        • Rate of Dose Change, Addition of, or Switching to a New Drug Among Patients Whose Symptoms Are Not Controlled on an ACE Inhibitor
        • Rate of Dose Change, Addition of, or Switching to a New Drug Among Patients Whose Symptoms Are Not Controlled on an AIIRA/ARB
        • Characteristics of Chronic Heart Failure Patients Initiated on Treatment with Entresto
      • Recent/Anticipated Changes in Brand Usage/Treatment Approach
        • Greater Experience with Newer Agents Drives Changes in Drug Usage
        • Changes in Overall Use of Treatment Approaches Over the Past Year in Patients with Chronic Heart Failure
        • Cardiologists’ Most Important Reasons for Increased Use of Drugs/Drug Classes in the Last Year
        • Cardiologists’ Most Important Reasons for Decreased Use of Drugs/Drug Classes in the Last Year
        • Expected Changes in Overall Use of Treatment Approaches in the Next Year for Patients with Chronic Heart Failure
        • Cardiologists’ Most Important Reason for Anticipated Increased Use of Drugs/Drug Classes in the Next Year
        • Cardiologists’ Most Important Reason for Anticipated Decreased Use of Drugs/Drug Classes in the Next Year
    • Physician Insight on Medical Practice
      • Key Findings
      • Drivers of Treatment Selection
        • Strong Outcomes Data Are a Key Driver Influencing Prescribers
        • Treatment Choice Is Influenced by a Drug’s Efficacy
        • Importance of Drug Attributes in Choice of Initial Therapy for Chronic Heart Failure Patients
        • Importance of Clinical Factors in Choice of Treatment for Chronic Heart Failure Patients
        • Influence of Non-Clinical Factors on Choice of Treatment for Chronic Heart Failure Patients
        • Efficacy Drives Prescribing
        • Superiority Across Clinical and Non-Clinical Attributes by Drug/Drug Class
        • Rates of Satisfaction with Chronic Heart Failure Drugs/Drug Classes
        • Rates of Satisfaction with Chronic Heart Failure Drugs/Drug Classes – Mean Values
        • Factors That Drive Prescribing or Use of Entresto for Chronic Heart Failure
        • Factors That Drive Prescribing or Use of Corlanor for Chronic Heart Failure
        • Cost/Reimbursement Barriers Constrain Prescribing of New Therapies
        • Factors That Constrain Prescribing of Entresto for Chronic Heart Failure
        • Factors That Constrain Prescribing of Corlanor for Chronic Heart Failure
        • Adverse Effects Are the Main Reason for Switching CHF Therapies
        • Therapy Discontinuation Is Uncommon in CHF
        • Most Common Reasons for the Discontinuation of a Chronic Heart Failure Drug/Drug Class
        • Treatment Deferral Is Advised Against in CHF
      • Face-to-Face Product Detailing Effectiveness
        • Prescribers Are Satisfied with Sales Efforts for Corlanor and Entresto
        • Sales Efforts for Corlanor and Entresto Have Been Frequent and Sustained
        • Cardiologists Ever Visited by a Sales Representative for Corlanor and Entresto
        • Number of Sales Representative Visits in the Past Six Months
        • Sales Representative Contact Rates
        • Availability of Samples or Vouchers During Recent Detail for Corlanor and Entresto
        • Ratings of Satisfaction with Sales Representatives are High
        • Satisfaction with Sales Representative Among Recently Detailed Physicians - Corlanor
        • Satisfaction with Sales Representative Among Recently Detailed Physicians - Entresto
        • Outcomes Benefits Are a Common Message in Recent Detailing Visits
        • Topics Discussed During the Most Recent Detail for Corlanor and Entresto
    • Methodology
      • Primary Market Research Methodology
      • Years in Practice Post-Residency
      • Chronic Heart Failure Patients Under Cardiologists’ Personal Management
      • Percentage of Chronic Heart Failure Patients with Reduced and Preserved Ejection Fraction
      • U.S. Region of Practice
      • Drugs/Drug Classes Prescribed for Chronic Heart Failure in the Past Year
      • Familiarity with Corlanor and Entresto Among Cardiologists
      • Cardiologists’ Practice Type
      • Cardiologists’ Practice Location
      • RWD Methodology
      • Limitations of Comparative Analyses Between Data Sources

Author(s): Dominika Rudnicka-Noulin, PhD, MSc

Dominika Rudnicka-Noulin, PhD, MSc is a senior business insights analyst in the Cardiovascular, Metabolic and Renal division at Decision Resources Group, specializing in cardiovascular diseases, with expertise in heart failure and acute coronary syndrome.

Prior to joining DRG, Dominika held a position of an associate editor at Nature Communications, working across a variety of therapy areas. Dominika also worked for three years as a Postdoctoral Research Associate on a joint project between Imperial College London and MedImmune aimed at developing more potent antibody-based drugs. Dominika gained her PhD at the Institut Pasteur in Paris, France where her work was funded by the European Commission Marie Skłodowska-Curie Actions


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