Heart failure drug gains new UK indication

 Pfizer’s drug Inspra (eplerenone) has been licensed in the UK for treatment of patients with chronic heart failure (CHF).

The new indication follows evidence that Inspra can reduce the risk of death or hospitalisation from heart failure in the relevant patient group by 37%.

The drug, already licensed for treatment of heart failure after recent myocardial infarction, can now be used to improve CHF patients’ health at an earlier stage.

The addition of Inspra to standard therapy has been shown to offer an incremental cost of £3,534 per QALY gained – well below the £20,000 threshold accepted as good value by NICE.

CHF affects over 875,000 people in the UK, and one in three patients die within a year of diagnosis while the rest suffer frequent hospitalisations lasting an average of 11 days.

Inspra, a selective aldosterone antagonist and mineralocorticoid receptor antagonist, is now approved for use with standard therapy in adult patients with CHF and left ventricular systolic dysfunction (LVEF) up to 30%.

It was already indicated to treat patients with heart failure and LVEF up to 40% after recent myocardial infarction, alongside standard therapy.

The EMPHASIS-HF trial showed that adding Inspra to the patient’s regime reduced the risk of death from cardiovascular causes or a first hospitalisation for heart failure by 37%.

Professor Martin Cowie, Consultant Cardiologist at the Royal Brompton Hospital, London, commented: “Patients with chronic heart failure have a shorter life expectancy than patients with the most common types of cancer and can require frequent admission to hospital. These admissions account for the majority of the costs associated with treating CHF.

“New strategies that have the potential to reduce these costs, as well as extending patients’ lives, are particularly welcome during these times of increased financial pressure.”