Availability And Accessibility To Optimal Medical Therapy For Heart Failure In Latin America And The Caribbean

• Published in: Journal of cardiac failure Vol. 30; no. 1; pp. 195 - 196
• Main Authors: Uribe, Francisco, Gomez-Mesa, Juan, Escalante, Manuela, URIBE, FRANCISCO, Speranza, Mario, Perna, Eduardo, Nuñez, Elaine, Soria, Israel Marín, Abi-Rezk, Manuel N., Rodriguez, David, Nunura, Felix
• Format: Journal Article
• Language: English
• Published: Elsevier Inc 01.01.2024
• ISSN: 1071-9164; 1532-8414
• DOI: 10.1016/j.cardfail.2023.10.192

The management of heart failure (HF) includes pharmacological strategies to control symptoms and increase survival rates. Current management guidelines provide recommendations about these strategies; however, their availability and access may be limited in different regions of the world, including Latin America and the Caribbean (LA&C). Evaluate the availability and accessibility to optimal medical therapy (OMT) for HF patients in LA&C, including beta blocker (BB), angiotensin converting enzyme inhibitor (ACEI) / angiotensin receptor antagonist (ARB) / angiotensin receptor-neprilysin inhibitor (ARNI), mineralocorticoid receptor antagonist (MRA) and sodium-glucose cotransporter-2 inhibitors (SGLT2i) The Council on Heart Failure and Pulmonary Hypertension (CIFACAH) of the Inter-American Society of Cardiology (SAIC) conducted a survey to evaluate the availability and access (cost paid by patient) of pharmacological, interventional and surgical options for HF in February 2023. Delegates from 21 LA&C countries that are part of the SIAC received and completed the survey. Regarding OMT, 100% of the countries have at least one BB, one ACEI, one ARB and one MRA available for HF treatment and ARNI and SGLT2i are available in 90% of countries (Table 1).The survey classified access to OMT as the percentage of the cost / value of medication that must be paid by the patient to access the specific therapy, as follows: 0%: No additional payment; <50%: pay for lest that 50% of the cost; 50-99%: Pay for most of the cost; 100%: Pay for all the cost.At least one BB of the OMT is available at 0% (No additional payment) in 76% of the countries, one ACEI / ARB / ARNI in 71%, one MRA in 71% and one SGLT2i in 42% of the countries (Table 2). By the other side, most of the available options for OMT are available in more than 86% of countries when patients can afford the hole cost (100%) of the medications. In most LA&C countries, OMT is available with at least one medication from each pharmacological group. Most of the countries have health care systems that cover a percentage of the medication cost. Based on that, few countries have access to OMT at no cost, but in most of the countries there is a possibility to access to at least one medication of the OMT paying 100% of the value of the medications.