First-line treatment of chronic heart failure (CHF) usually involves a beta blocker, an angiotensin-converting enzyme (ACE) inhibitor, and an oral diuretic. Second- or third-line treatments are often needed to better manage the disease. Physicians have numerous drug classes to choose from, most of which consist of drug options. The CHF market is heavily genericized, as such physician practice is minimally impacted by pricing pressures. The CHF Treatment Algorithm offers insight into prescribing patterns in this multi-layered treatment landscape where few branded agents jostle for patient share in a crowded sector. That said, small patient shares for such a prevalent indication can translate into significant commercial positions.