Treatment of HF in an Era of Multiple Therapies: Statement From the HF Collaboratory

Statement From the HF Collaboratory

Ankeet S. Bhatt, MD, MBA; William T. Abraham, MD; JoAnn Lindenfeld, MD; Michael Bristow, MD; Peter E. Carson, MD; G. Michael Felker, MD, MHS; Gregg C. Fonarow, MD; Stephen J. Greene, MD; Mitchell A. Psotka, MD, PHD; Scott D. Solomon, MD; Norman Stockbridge, MD, PHD; John R. Teerlink, MD; Muthiah Vaduganathan, MD, MPH; Janet Wittes, PHD; Mona Fiuzat, PHARMD; Christopher M. O'Connor, MD; Javed Butler, MD, MPH, MBA


JACC Heart Fail. 2021;9(1):1-12. 

In This Article

Practical Considerations

Cost, access, availability, tolerability, and monitoring all play important roles in defining potential algorithms for the initiation and uptitration of novel therapies. Drug pricing, insurance status, and formulary coverage are critical issues but may become less relevant over time, allowing for more traditional scientific determinants in drug selection decisions. Patient factors related to polypharmacy are important, particularly in patients with many comorbid conditions.[34] Standardized assessments of the magnitude of clinical benefits must be balanced by considerations of ease of use, tolerability, and costs when engaging in shared decision-making, and both patients and providers should agree that the benefits of incremental therapy outweigh potential costs/risks. Despite all these issues, scientific determinants should primarily guide therapeutic decisions, and other real-world considerations should only secondarily modulate evidence-based information.