Sacubitril–Valsartan in Heart Failure
Authors: Brad Spellberg
Journal: Annals of Internal Medicine (2017)

Letters2 May 2017Sacubitril–Valsartan in Heart FailureBrad Spellberg, MDBrad Spellberg, MDFrom LAC+USC Medical Center and Keck School of Medicine at USC, Los Angeles, California.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/L17-0047 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail TO THE EDITOR:Packer and colleagues (1) speculate why sacubitril–valsartan has not had more uptake as a therapy for heart failure in the United States despite being cost-effective from a societal perspective. Potential explanations for this phenomenon are barriers to adding the drug to formularies and concerns about potential future adverse effects. A payer must bear the additional expense of a new drug that meets societal standards for cost-effectiveness but does not reduce costs. In traditional outpatient fee-for-service models, society has been a primary payer (for example, through Medicare part D or private insurance premiums); thus, societal estimates of cost-effectiveness ...References1. Packer M, Armstrong WM, Rothstein JM, Emmett M. Sacubitril–valsartan in heart failure: why are more physicians not prescribing it?. Ann Intern Med. 2016;165:735-6. [PMID: 27571568]. doi:10.7326/M16-1932 LinkGoogle Scholar2. Schrag D. Reimbursing Wisely? CMS's trial of Medicare part B drug payment reform. N Engl J Med. 2016;374:2101-5. [PMID: 27248616] doi:10.1056/NEJMp1603735 CrossrefMedlineGoogle Scholar3. Obama B. United States health care reform: progress to date and next steps. JAMA. 2016;316:525-32. [PMID: 27400401] doi:10.1001/jama.2016.9797 CrossrefMedlineGoogle Scholar4. Spellberg B, Bartlett JG, Gilbert DN. How to pitch an antibiotic stewardship program to the hospital C-suite. Open Forum Infect Dis. 2016;3:ofw210. [PMID: 27844028] CrossrefMedlineGoogle Scholar5. Farris W, Schütz SG, Cirrito JR, Shankar GM, Sun X, George A, et al. Loss of neprilysin function promotes amyloid plaque formation and causes cerebral amyloid angiopathy. Am J Pathol. 2007;171:241-51. [PMID: 17591969] CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAffiliations: From LAC+USC Medical Center and Keck School of Medicine at USC, Los Angeles, California.Disclosures: Disclosures can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=L17-0047. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoSacubitril–Valsartan in Heart Failure: Why Are More Physicians Not Prescribing It? Milton Packer , W. Mark Armstrong , Joseph M. Rothstein , and Michael Emmett Sacubitril–Valsartan in Heart Failure Kevin E. Vitting Sacubitril–Valsartan in Heart Failure Bennett E. Werner Sacubitril–Valsartan in Heart Failure Milton Packer , W. Mark Armstrong , Joseph M. Rothstein , and Michael Emmett Metrics 2 May 2017Volume 166, Issue 9Page: 680KeywordsAlzheimer diseaseBrainDisclosureDrugsHealth careHeart failureInsuranceMedicareOutpatientsPopulation statistics ePublished: 2 May 2017 Issue Published: 2 May 2017 Copyright & PermissionsCopyright © 2017 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...