Heart Failure – Unmet Need – Detailed, Expanded Analysis Preserved Ejection Fraction (US/EU)
Heart failure with preserved ejection fraction (HFpEF) accounts for approximately half of all chronic heart failure (CHF) cases, but proven pharmacological treatment options are limited. In February 2021, the FDA approved Entresto, an angiotensin receptor-neprilysin inhibitor (ARNI) marketed by Novartis for HFpEF, making it the first approved therapy for this subpopulation. Despite a long list of clinical trial failures, the HFpEF pipeline has some promising candidates, such as sodium-glucose cotransporter-2 (SGLT-2) inhibitors and mineralocorticoid receptor antagonists (MRAs). Substantial market opportunity remains for effective therapies to treat this heterogeneous and highly prevalent population.
QUESTIONS ANSWERED
- Which drug attributes are the most influential in driving cardiologists’ prescribing decisions?
- Which therapies used in the treatment of HFpEF do cardiologists perceive as performing the best on efficacy, safety and tolerability, and convenience of administration attributes?
- What are the major areas of opportunity for drug developers in HFpEF treatment, and what is their likelihood of being fulfilled in the near future?
- What are the trade-offs that surveyed cardiologists are willing to make across key attributes when considering new treatments for HFpEF?
PRODUCT DESCRIPTION
Unmet Need provides quantitative insight into U.S. and European physician perceptions of key treatment drivers and goals and the current level of unmet need for a specific disease. Commercial opportunities are analyzed, and the extent to which emerging therapies may capitalize on these opportunities is evaluated.
Markets covered: United States, United Kingdom, France, Germany
Primary research: Survey of 60 U.S. and 30 European cardiologists fielded in March 2021.
Key companies: Novartis, Pfizer
Key drugs: ACE inhibitors, ARBs, ARNIs (Entresto, sacubitril / valsartan), beta blockers, calcium channel blockers, diuretics, MRAs
Table of contents
- Heart Failure - Unmet Need - Detailed, Expanded Analysis Preserved Ejection Fraction (US/EU)
- Executive Summary
- Unmet Need - Heart Failure with Preserved Ejection Fraction - Executive Summary - June 2021
- Introduction
- Overview
- Methodology
- Rationale for Treatment Drivers and Goals Selection
- Rationale for Drug Selection
- Products for Heart Failure with Preserved Ejection Fraction and Rationale for Drug Class Selection
- Treatment Drivers and Goals
- Key Findings: Attribute Importance
- Relative Importance of Efficacy, Safety and Tolerability, Convenience of Administration, and Nonclinical Attributes to Surveyed Cardiologists' Prescribing Decisions in Heart Failure with Preserved Ejection Fraction
- Importance of Efficacy Attributes to Prescribing Decisions in Heart Failure with Preserved Ejection Fraction: United States
- Importance of Efficacy Attributes to Prescribing Decisions in Heart Failure with Preserved Ejection Fraction: Europe
- Importance of Safety and Tolerability Attributes to Prescribing Decisions in Heart Failure with Preserved Ejection Fraction: United States
- Importance of Safety and Tolerability Attributes to Prescribing Decisions in Heart Failure with Preserved Ejection Fraction: Europe
- Importance of Convenience of Administration Attributes to Prescribing Decisions in Heart Failure with Preserved Ejection Fraction: United States
- Importance of Convenience of Administration Attributes to Prescribing Decisions in Heart Failure with Preserved Ejection Fraction: Europe
- Key Findings: Stated vs. Derived Importance
- Stated vs. Derived Importance of Key Efficacy, Safety and Tolerability, and Convenience of Administration Attributes to Prescribing Decisions in Heart Failure with Preserved Ejection Fraction: United States
- Stated vs. Derived Importance of Key Efficacy, Safety and Tolerability, and Convenience of Administration Attributes to Prescribing Decisions in Heart Failure with Preserved Ejection Fraction: Europe
- Product Performance Against Treatment Drivers and Goals
- Key Findings
- Overall Performance of Key Therapies for Heart Failure with Preserved Ejection Fraction: United States
- Overall Performance of Key Therapies for Heart Failure with Preserved Ejection Fraction: Europe
- Mean Overall Performance of Key Therapies for Heart Failure with Preserved Ejection Fraction: United States and Europe
- Relative Performance of Key Therapies for Heart Failure with Preserved Ejection Fraction Across Select Efficacy Attributes: United States
- Relative Performance of Key Therapies for Heart Failure with Preserved Ejection Fraction Across Select Efficacy Attributes: Europe
- Relative Performance of Key Therapies for Heart Failure with Preserved Ejection Fraction Across Select Safety and Tolerability Attributes: United States
- Relative Performance of Key Therapies for Heart Failure with Preserved Ejection Fraction Across Select Safety and Tolerability Attributes: Europe
- Relative Performance of Key Therapies for Heart Failure with Preserved Ejection Fraction Across Select Convenience of Administration Attributes: United States
- Relative Performance of Key Therapies for Heart Failure with Preserved Ejection Fraction Across Select Convenience of Administration Attributes: Europe
- Assessment of Unmet Need
- Key Findings: Unmet Need in Heart Failure with Preserved Ejection Fraction
- Surveyed Cardiologistsu2019 Satisfaction with the Performance of Key Therapies for Heart Failure with Preserved Ejection Fraction on Efficacy, Safety and Tolerability, Convenience of Administration, and Nonclinical Factors: United States
- Surveyed Cardiologistsu2019 Satisfaction with the Performance of Key Therapies for Heart Failure with Preserved Ejection Fraction on Efficacy, Safety and Tolerability, Convenience of Administration, and Nonclinical Factors: Europe
- Surveyed Cardiologists' Ascribed Level of Unmet Need Across Key Efficacy Attributes in Heart Failure with Preserved Ejection Fraction: United States
- Surveyed Cardiologists' Ascribed Level of Unmet Need Across Key Efficacy Attributes in Heart Failure with Preserved Ejection Fraction: Europe
- Surveyed Cardiologists' Ascribed Level of Unmet Need Across Key Safety and Tolerability Attributes in Heart Failure with Preserved Ejection Fraction: United States
- Surveyed Cardiologists' Ascribed Level of Unmet Need Across Key Safety and Tolerability Attributes in Heart Failure with Preserved Ejection Fraction: Europe
- Surveyed Cardiologists' Ascribed Level of Unmet Need Across Key Convenience of Administration Attributes in Heart Failure with Preserved Ejection Fraction: United States
- Surveyed Cardiologists' Ascribed Level of Unmet Need Across Key Convenience of Administration Attributes in Heart Failure with Preserved Ejection Fraction: Europe
- Key Findings: Unmet Need in Heart Failure with Preserved Ejection Fraction and Related Indications
- Surveyed Cardiologists' Ascribed Level of Unmet Need in Heart Failure with Preserved Ejection Fraction and Related Indications: United States
- Surveyed Cardiologists' Ascribed Level of Unmet Need in Heart Failure with Preserved Ejection Fraction and Related Indications: Europe
- Opportunity Analysis
- Areas of Opportunity in the Heart Failure with Preserved Ejection Fraction Market and Emerging Therapy Insights
- Opportunity: An Agent That Can Improve CV Mortality and Lower the Rate of Hospitalization in HFpEF Patients
- Opportunity: An Agent That Can Improve HFpEF Patients' Exercise Capacity
- Areas of Opportunity in the Heart Failure with Preserved Ejection Fraction Market and Emerging Therapy Insights
- Target Product Profiles
- Assessing Drug Development Opportunities
- Target Product Profile Methodology
- Attributes and Attribute Levels
- Attribute Importance and Part-Worth Utilities
- Heart Failure with Preserved Ejection Fraction Target Product Profile: Attribute Importance
- Rate of CV Mortality
- Rate of Hospitalization for Heart Failure
- Change in 6MWD (Meters)
- Proportion of Patients Reporting NYHA Improvement
- Rate of Adverse Renal Outcomes
- Dosing
- Price per Day of Therapy
- Conjoint Analysis-Based Simulation of a Market Scenario
- Heart Failure with Preserved Ejection Fraction Market Simulation: Share of Preference of Target Product Profiles Included in the Market Scenario
- Heart Failure with Preserved Ejection Fraction Market Simulation: Likelihood to Prescribe Target Product Profiles Included in the Market Scenario
- Heart Failure with Preserved Ejection Fraction Market Simulation: Target Product Profiles Included in the Market Scenario
- Appendix
- Bibliography
- Executive Summary
Shambhavi Shukla, MTech., is an analyst on the Cardiovascular, Metabolic, Renal, and Hematologic (CMRH) Disorders team at Clarivate. Before joining Clarivate, Shambhavi was with Evalueserve for four years, where she worked closely with top pharmaceutical companies, helping them with commercial and technical ad-hoc requests. She has delivered competitive landscape and market insight projects for various indications, including Schizophrenia, Multiple Sclerosis, Myopia, Osteoporosis, and FSGS. She holds a master’s degree in biotechnology from Amity University, India.