{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,13]],"date-time":"2026-10-13T00:13:31Z","timestamp":1791850411462,"version":"4.3.4"},"reference-count":33,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"2","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["Circ: Heart Failure"],"published-print":{"date-parts":[[2018,2]]},"abstract":"<jats:sec>\n            <jats:title>Background:<\/jats:title>\n            <jats:p>The US Food and Drug Administration approved the use of sacubitril\/valsartan in patients with heart failure with reduced ejection fraction in July 2015. We aimed to assess the adoption and prescription drug costs of sacubitril\/valsartan in its first 18 months after Food and Drug Administration approval.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Methods and Results:<\/jats:title>\n            <jats:p>Using a large US insurance database, we identified privately insured and Medicare Advantage beneficiaries who filled a first prescription for sacubitril\/valsartan between July 1, 2015, and December 31, 2016. We compared them to patients treated with an angiotensin-converting enzyme inhibitor or angiotensin receptor blocker. Outcomes included adoption, prescription drug costs, and 180-day adherence, defined as a proportion of days covered \u226580%. A total of 2244 patients initiated sacubitril\/valsartan. Although the number of users increased over time, the proportion of heart failure with reduced ejection fraction patients taking sacubitril\/valsartan remained low (&lt;3%). Patients prescribed sacubitril\/valsartan were younger, more often male, with less comorbidity than those taking an angiotensin-converting enzyme inhibitor\/angiotensin receptor blocker. Although a majority of prescription costs were covered by the health plan (mean, $328.37; median, $362.44 per 30-day prescription), out-of-pocket costs were still high (mean, $71.16; median, $40.27). By comparison, median out-of-pocket costs were $2 to $3 for lisinopril, losartan, carvedilol, and spironolactone. Overall, 59.1% of patients were adherent to sacubitril\/valsartan. Refill patterns suggested that nearly half of nonadherent patients discontinued sacubitril\/valsartan within 180 days of starting.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusions:<\/jats:title>\n            <jats:p>Adoption of sacubitril\/valsartan after Food and Drug Administration approval has been slow and may be associated with the high cost.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1161\/circheartfailure.117.004302","type":"journal-article","created":{"date-parts":[[2018,2,17]],"date-time":"2018-02-17T01:10:20Z","timestamp":1518829820000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":86,"title":["Adoption of Sacubitril\/Valsartan for the Management of Patients With Heart Failure"],"prefix":"10.1161","volume":"11","author":[{"given":"Lindsey R.","family":"Sangaralingham","sequence":"first","affiliation":[{"name":"From the Robert D. and Patricia E. Kern Center for the Science of Healthcare Delivery (L.R.S., N.D.S., X.Y.), Department of Cardiovascular Medicine (S.J.S., S.M.D.), and Department of Health Sciences Research (N.D.S., X.Y., S.M.D.), Mayo Clinic, Rochester, MN; and OptumLabs, Cambridge, MA (N.D.S.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"S. Jeson","family":"Sangaralingham","sequence":"additional","affiliation":[{"name":"From the Robert D. and Patricia E. Kern Center for the Science of Healthcare Delivery (L.R.S., N.D.S., X.Y.), Department of Cardiovascular Medicine (S.J.S., S.M.D.), and Department of Health Sciences Research (N.D.S., X.Y., S.M.D.), Mayo Clinic, Rochester, MN; and OptumLabs, Cambridge, MA (N.D.S.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nilay D.","family":"Shah","sequence":"additional","affiliation":[{"name":"From the Robert D. and Patricia E. Kern Center for the Science of Healthcare Delivery (L.R.S., N.D.S., X.Y.), Department of Cardiovascular Medicine (S.J.S., S.M.D.), and Department of Health Sciences Research (N.D.S., X.Y., S.M.D.), Mayo Clinic, Rochester, MN; and OptumLabs, Cambridge, MA (N.D.S.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiaoxi","family":"Yao","sequence":"additional","affiliation":[{"name":"From the Robert D. and Patricia E. Kern Center for the Science of Healthcare Delivery (L.R.S., N.D.S., X.Y.), Department of Cardiovascular Medicine (S.J.S., S.M.D.), and Department of Health Sciences Research (N.D.S., X.Y., S.M.D.), Mayo Clinic, Rochester, MN; and OptumLabs, Cambridge, MA (N.D.S.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shannon M.","family":"Dunlay","sequence":"additional","affiliation":[{"name":"From the Robert D. and Patricia E. Kern Center for the Science of Healthcare Delivery (L.R.S., N.D.S., X.Y.), Department of Cardiovascular Medicine (S.J.S., S.M.D.), and Department of Health Sciences Research (N.D.S., X.Y., S.M.D.), Mayo Clinic, Rochester, MN; and OptumLabs, Cambridge, MA (N.D.S.)."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"e_1_3_4_2_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIR.0000000000000485"},{"key":"e_1_3_4_3_2","doi-asserted-by":"publisher","DOI":"10.1007\/s11897-014-0220-x"},{"key":"e_1_3_4_4_2","doi-asserted-by":"publisher","DOI":"10.1001\/jama.292.3.344"},{"key":"e_1_3_4_5_2","doi-asserted-by":"publisher","DOI":"10.1038\/nrd2219"},{"key":"e_1_3_4_6_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1409077"},{"key":"e_1_3_4_7_2","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehw128"},{"key":"e_1_3_4_8_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIR.0000000000000509"},{"key":"e_1_3_4_9_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCOUTCOMES.116.002653"},{"key":"e_1_3_4_10_2","doi-asserted-by":"publisher","DOI":"10.1377\/hlthaff.2014.0038"},{"key":"e_1_3_4_11_2","doi-asserted-by":"publisher","DOI":"10.1002\/pds.2146"},{"key":"e_1_3_4_12_2","doi-asserted-by":"publisher","DOI":"10.1001\/archinternmed.2007.80"},{"key":"e_1_3_4_13_2","doi-asserted-by":"publisher","DOI":"10.1097\/01.mlr.0000182534.19832.83"},{"key":"e_1_3_4_14_2","doi-asserted-by":"publisher","DOI":"10.1345\/aph.1H018"},{"key":"e_1_3_4_15_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.115.018622"},{"key":"e_1_3_4_16_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCHEARTFAILURE.112.000289"},{"key":"e_1_3_4_17_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jchf.2016.12.018"},{"key":"e_1_3_4_18_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM199909023411001"},{"key":"e_1_3_4_19_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa040135"},{"key":"e_1_3_4_20_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2017.03.540"},{"key":"e_1_3_4_21_2","first-page":"e224","article-title":"Adoption of new agents and changes in treatment patterns for hepatitis C: 2010-2014.","volume":"22","author":"Yao X","year":"2016","unstructured":"Yao X, Sangaralingham LR, Ross JS, Shah ND, Talwalkar JA. 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