Chronic Heart Failure | Treatment Algorithms | Claims Data Analysis | US | 2014

Heart failure describes a pathophysiological state in which the heart is unable to efficiently supply the body with oxygenated blood in order to meet the body’s metabolic demands. While acute heart failure (AHF) describes a rapid worsening of heart failure symptoms resulting in hospitalization, chronic heart failure (CHF) describes the long-term duration of this syndrome. The disease progression of CHF is a gradual process that is heavily influenced by patient comorbidities such as hypertension, coronary artery disease (CAD), diabetes, and age. Patients with CHF exhibit high rates of mortality and other complications resulting from disease morbidity and symptoms, although mortality and complication rates depend on the level of disease progression. Although survival rates and times for CHF have improved, the primary treatment goal remains to prolong patient survival. Another key treatment goal is preventing the worsening of heart failure symptoms that could result in acute decompensation and hospitalization. First-line treatment of CHF usually involves an angiotensin-converting enzyme (ACE) inhibitor, oral beta blocker, and oral diuretic. The addition of second- or third-line agents, such as a mineralocorticoid receptor antagonist or a digitalis glycoside, is often dictated by risk factors, disease severity, and, to a lesser extent, patient symptoms. Using national patient-level claims data, this report analyzes physician adherence to CHF treatment guidelines by exploring the use of key therapies in the newly diagnosed and recently treated CHF patient populations. With respect to newly diagnosed patients, the report provides a quantitative analysis of treatment patterns and share by line of therapy, as well as progression between lines, duration of treatment on each line, and use of concomitant treatment. For recently treated patients, the report quantifies a drug’s source of business compared with that of its competitors and details which drugs precede others by analyzing add-versus-switch patterns. Additional analyses explore persistency and compliance by brand.