Decision Resources: 52% of surveyed cardiologists identify furosemide as efficacious acute heart failure therapy

Decision Resources, one of the world's leading research and advisory firms for pharmaceutical and healthcare issues, finds that the highest proportion of surveyed cardiologists (52 percent) identify furosemide (Sanofi-Aventis's Lasix, generics) as the most efficacious agent for the treatment of acute heart failure when compared to other available therapies. Furosemide, the patient-share leader in the indication, was also chosen by 35 percent of surveyed managed care organizations' (MCO) pharmacy directors as the most efficacious acute heart failure therapy.

The DecisionBase 2011 report entitled Acute Heart Failure: Significant Opportunity Awaits Agents That Reduce Mortality and Rehospitalization, But Will Emerging Agents Such as Relaxin Meet These Unmet Needs?, finds that both surveyed cardiologists and payers who chose furosemide as the most efficacious agent are most satisfied with the drug's effect on the symptoms of dyspnea as the administration of IV furosemide offers rapid symptomatic relief of dyspnea during the first few hours of treatment. However, both cardiologists and payers are least satisfied with furosemide's effect on the rate of mortality, which may be owing to a lack of evidence of a significant mortality benefit of diuretics.

"Payers may be less familiar with diuretics than cardiologists in the hospital setting or more skeptical about the increased risk of death with high-dose diuretics," said Decision Resources Analyst Taskin Ahmed. "Although high-dose diuretic therapy is a marker for increased mortality during hospitalization for heart failure, it is unclear whether this is a direct adverse effect of diuretics or a reflection of the severity of heart failure."

The findings also reveal that, based on clinical data and the opinions of interviewed thought leaders, furosemide is the current gold-standard therapy for the treatment of acute heart failure, owing to its strong clinical profile among key marketed products for the indication. However, owing to its advantages in efficacy and safety and tolerability, Novartis's relaxin will displace furosemide and will earn Decision Resources' proprietary clinical gold-standard status for acute heart failure in 2019, following its launch for the indication in 2014.

Additionally, surveyed cardiologists and pharmacy directors agree that effect on the rate of mortality is one of the attributes that most influences their decisions regarding prescribing and tier placement decisions, respectively, in acute heart failure. Clinical data and the opinions of interviewed thought leaders indicate that relaxin may have advantages over current therapies on this attribute.