New heart failure drug Entresto to be available on the NHS

31st March 2016

NICE has confirmed that the new heart failure drug Entresto will be available on the NHS for some adult patients.

Those who qualify must have a reduced pumping action of the heart and have heart failure symptoms causing limitations to their activities.

Final guidance from NICE on the Novartis drug, containing sacubitril and valsartan, says it can be used to treat adults with symptomatic chronic heart failure (fitting the New York Heart Association’s class 11 to 1V), a left ventricular ejection fraction of 35 per cent or less, and who are on a stable dose of ACE inhibitors or ARBs.

The NYHA classes cover most patients with heart failure symptoms, but not those with class 1 symptoms (no limitations to physical activity and ordinary physical activity does not cause undue fatigue, palpitation and shortness of breath).

The guidance for England and Wales is a narrower indication than that approved by the Scottish Medicines Consortium, which has given the go-ahead for the drug's approved indication in the EU. So access to Entresto will be different in Scotland to the rest of the mainland.

Dr Dimitrios Georgiopoulos, Novartis Pharmaceuticals UK's medical director, said: “The recommendation from NICE represents an important milestone. However, due to NICE's restrictions on eligible patients, not all patients will have access to this breakthrough treatment on the NHS."

In studies, Entresto was shown to improve survival. The results of the PARADIGM-HF study showed that patients treated with the drug, rather than the ACE inhibitor enalapril, were 20% less likely to die from a cardiovascular cause or be admitted to hospital, and were also 16% less likely to die from any cause in the study period.

Entresto, which is already available through the UK’s Early Access to Medicines Scheme, offers a novel dual action treatment. The twice-a-day tablet enhances the protective neurohormonal systems of the heart while simultaneously suppressing the harmful system.