Entresto leaves too many questions for the $$

[anonymous]

http://www.forbes.com/sites/davidgr...the-superiority-of-entresto-just-an-illusion/

Enalapril 10mg bid as a comparator is not a standard of care. Titration should have occurred, or a second arm vs valsartan (to determine the true value of the second molecule).

I wish you the best gaining formulary access with such a high cost vs many cost/benefit questions. I'm a pharmacy director and my sister works for Novartis so I pay attention to this.

 

[anonymous]

The liability lies with the treating clinician not the payer- watchout... lawsuits will fly with any assoication of mortality and patient care not cost of drug.

 

[anonymous]

http://www.forbes.com/sites/davidgr...the-superiority-of-entresto-just-an-illusion/

Enalapril 10mg bid as a comparator is not a standard of care. Titration should have occurred, or a second arm vs valsartan (to determine the true value of the second molecule).

I wish you the best gaining formulary access with such a high cost vs many cost/benefit questions. I'm a pharmacy director and my sister works for Novartis so I pay attention to this.

Funny... Pharm D.. sure.. this article is clearly biased.. a very large, well designed clinical trial for HfRef with meaningful outcomes. Benefits in the treatment of CHF with the advent of new classes of meds, historically have been incremental, yet clinically important.. as seen in PARADIGM.. The active comparator was valid based on the clinical evidence available supporting the dose of Enalipril. The data isnt available to support pushing higher doses..The ACC/AHA guidelines suppport those doses, considering no trials have shown high doses of ACEI's are more beneficial.. only high vs low dose/bare minimum doses displayed minor benefits..The PKS9 inhibitors have absolutely NO outcomes data and many physicians agree that if a patient is compliant with max doses of Statins, and are in dietary compliance, 95% won't need this class.. others with genetic disorders and/or family history of high LDL and uncontrolled on standard of care therapy, and compliant are solid candidates.

I'd bet the naysayers who discount the data would be pleading to their Cardiologist if he/she or someone they love is suffering from CHF complications, to initiate Entresto.. I'd bet a lot those requests would invariably occur..

 

[anonymous]

Response above well stated. Appreciate the dialogue