Heart failure & cardiomyopathiesCohort study
Direct-to-Physician Marketing and Uptake of Optimal Medical Therapy for Heart Failure With Reduced Ejection Fraction
- Retrospective cohort study
- Medicare Part D data
- negative binomial regression
Authors' conclusion
Industry marketing to general cardiologists is associated with increased uptake of ARNIs and SGLT2is, but not with increased uptake of all pillars of GDMT.
Study context
- Population
- General and advanced HF cardiologists prescribing guideline-directed medical therapy (GDMT) for HFrEF under Medicare Part D, 2019–202111,277 general + 329 advanced heart failure (AHF) cardiologists
- Exposure
- Industry marketing meals vs none and GDMT prescribing
- Outcome
- Prescribing rates of marketed and un-marketed GDMT classes
Main finding
As reported in the abstract
ARNI prescribing volume in 2021 by ARNI marketing meals in 2020 (general cardiologists) · 2021
Relative ratio
- 1-4 ARNI meals
- 1.43 (95% CI 1.34–1.53)
- 5-9 ARNI meals
- 1.69 (95% CI 1.48–1.93)
- ≥10 ARNI meals
- 2.09 (95% CI 1.80–2.43)
Observational data: associations, not effects.
Further findings
Receipt of marketing payments, 2019–2021
- Cardiologists receiving ARNI marketing payments
- 60%
- Cardiologists receiving SGLT2i marketing payments
- 50%
SGLT2i prescribing by SGLT2i marketing
- Findings similar to ARNI
Prescribing of other GDMT pillars, incl. Mineralocorticoid receptor antagonists (MRAs)
- Association inconsistent across drug classes
- Neither ARNI nor SGLT2i marketing consistently associated with increased MRA prescribing
Original publication
Direct-to-Physician Marketing and Uptake of Optimal Medical Therapy for Heart Failure With Reduced Ejection Fraction. JACC Heart Fail. Published 19 March 2025. doi:10.1016/j.jchf.2024.11.020
Summarised from the published abstract; every number is checked against it