Hypertension – Unmet Need – Unmet Need – Resistant Hypertension (US/EU)

Resistant hypertension (RHTN) has become a critical focus within the cardiovascular market because a substantial proportion of patients remain uncontrolled despite multidrug therapy, with longestablished regimens centered on RAAS inhibitors (ACE inhibitors or ARBs), CCBs, thiazide-like diuretics, and the addition of spironolactone as the standard fourthline agent continuing to dominate care due to decades of clinician familiarity. Although these therapies are widely used, important gaps remain, fueling interest in emerging treatments from companies developing new mechanisms of action. The recent approval of Idorsia’s aprocitentan (Tryvio / Jeragyo), the first new antihypertensive class in nearly 40 years, signals a meaningful change in this genericized landscape and highlights the importance of understanding how prescriber expectations are shifting. In this report, we explore which attributes cardiologists value most in current and future RHTN treatments, and through the TPP Simulator, we assess how physicians prioritize efficacy, safety, and other key product features in terms of efficacy and safety.

QUESTIONS ANSWERED

• How do cardiologists distinguish between established RHTN treatments and newer alternatives such as aprocitentan when assessing clinical and nonclinical factors?
• Which drug attributes most influence a cardiologist’s prescribing decisions in RHTN?
• What trade-offs across different clinical attributes and price are acceptable to U.S. and European cardiologists for an emerging therapy?
• What are the prevailing areas of unmet need in treating RHTN?

Markets covered: United States, France, Germany, United Kingdom

Primary research: Survey of 61 U.S. and 30 European endocrinologists fielded in June 2026

Key companies: Idorsia Pharmaceuticals, Pfizer, Viatris, Validus Pharmaceuticals, Waylis Therapeutics, Cheplapharm, Recordati Pharmaceuticals.

Key drugs: Tryvio, spironolactone, carvedilol, metoprolol, clonidine, doxazosin

PRODUCT DESCRIPTION

Unmet Need offers insight into key treatment drivers and goals, the performance of current therapies, and the remaining commercial opportunities, enabling you to:

• Evaluate clinical and nonclinical product attributes that influence treatment decisions through physicians’ weightings and analysis of stated vs. derived importance.
• Pinpoint areas of high unmet need by assessing current drug performance against key attributes and treatment drivers.
• Analyze market scenarios for different target product profiles using the TPP Simulator.