Impact of Heart Failure Guideline Publication on Medicare Drug Coverage Policies: A Quasi-Experimental Analysis.

ABSTRACT:

Background

Patients with heart failure (HF) often have difficulty obtaining life-saving medications due to coverage barriers, such as prior authorizations and high out-of-pocket costs. To promote better coverage for high value therapies and inform policymakers about cost effectiveness, the American Heart Association/American College of Cardiology/Heart Failure Society of America added Value Statements to HF guidelines. We assessed whether these guidelines influenced Medicare drug coverage policies for 2 life-saving, costly HF medications: angiotensin receptor neprilysin inhibitors (ARNI-guideline "high value") and sodium glucose cotransporter-2 inhibitors (SGLT2i-guideline "intermediate value").

Methods

We performed an observational study using Medicare prescription drug pla

SUBMITTER: Mukhopadhyay A 

PROVIDER: S-EPMC12684512 | biostudies-literature | 2025 Oct

REPOSITORIES: biostudies-literature