Overcoming Financial Barriers to GDMT in Heart Failure, with Lauren Eyadiel, MMS, PA-C

With most newer medications, cost remains a significant hurdle to optimal uptake and prescription. Heart failure is a prime example.

Within the field, clinicians and researchers find themselves witnessing an incredible contrast between the advances in medical therapy within the last decade against the uptake of these therapies, with SGLT2 inhibitors serving as a prime example of these struggles.

A study published in the Journal of the American College of Cardiology in March 2023 provided insight into the cost of SGLT2 inhibitors in heart failure with preserved ejection fraction (HFpEF). In the study, which used a state-transition model to simulate monthly health outcomes and direct healthcare costs, results indicated standard of care plus SGLT2 inhibitors increased quality-adjusted survival by 0.19 QALYs at a cost of an additional $26,300 compared with standard of care alone. Investigators highlighted the incremental cost-effectiveness ratio was $141,200 per QALY gained, with 59.1% of 1000 probabilistic iterations classified as intermediate value and adding SGLT2 inhibitors to standard of care in all eligible US adults with HFpEF could increase annual healthcare spending by $8.6 billion.

At the Heart Failure Society of America 2023 Annual Scientific Meeting, optimization of guideline-directed medical therapy in heart failure was a main focal point of many discussions, including a special session led by Sarah Schroeder, PhD, RN, of Bryan Health, and Muthiah Vaduganathan, MD, MPH, of Brigham and Women’s Hospital, titled “Novel Implementation Strategies and How-To”. Within this session was a presentation led by Lauren Eyadiel, MMS, PA-C, assistant professor at Wake Forest University School of Medicine, examining financial barriers to guideline-directed medical therapy. With an interest in learning more about her presentation, the editorial team of HCPLive Cardiology sat down with Eyadiel for a discussion on financial barriers to optimization, other contemporary hurdles to optimal uptake, and the role of advanced practice providers in implementation science.

Eyadiel has no disclosure to note.