• Jeenal Patel.
• Associate director of Formulary Design and Strategy, Oscar Health, New York, NY. Email: jbpatel06@gmail.com.
• Am J Manag Care. 2021 Jun 1; 27 (9 Suppl): S191-S195.

AbstractThe United States has an increasing number of patients with heart failure (HF) who experience significant disease burden as well as contribute to high economic healthcare costs and usage of healthcare resources. HF costs are currently estimated at $30.7 billion. If no improvements are made to current treatment outcomes, it is expected to grow to $69.8 billion by the year 2030. Hospital admissions account for the driving factor of direct medical costs. There has been increased focus on decreasing HF-related hospital readmission rates in the United States for the past decade; however, few interventions have positively affected hospital readmission rates. Some transitional care programs have been successful at positively affecting readmissions, though not all programs have demonstrated improvement of end points. These mixed program outcomes show the importance of evaluating HF-related transitional care program components for future directions. Newly approved treatments for HF with preserved ejection fraction may improve clinical outcomes for these patients. Pharmacists and physicians can help improve access to HF medications by assisting patients on how to navigate manufacturer assistance programs, submitting complete and well-supported prior authorization forms when needed, and encouraging the use of pharmacy price matching and price checkers.

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