neprilysin_1r1hEntresto is a new medication for the treatment of Heart Failure from Novartis.  It is proven to reduce symptoms, hospitalizations and to prolong life in patients with symptomatic heart failure with a reduced heart pump capacity (below 40% ejection fraction.)

Congestive Heart Failure is among the most costly diseases in the US due to the high price of hospital treatment for these patients. Over the past 30 years I’ve seen basic scientific research show that perfecting the hormonal milieu through the blockage of various receptors (angiotensin receptors, beta receptors) has the greatest impact on heart failure patients longevity.    With the introduction of Entresto, an old medication Valsartan is combined with a new drug called Sacubitril.  Sacubitril blocks neprilysin, an enzyme involved in fluid balance in the vascular system.

Issues related to this new medication include tolerability (low blood pressure, allergic swelling, and potassium/sodium variations are among the aspects that need to be monitored) and cost.   At the current time, the standard heart failure treatment regimen has an enormous positive impact on longevity and symptoms, and due to the fact that virtually all of these medications are off patent, it currently costs only pennies per day to treat heart failure effectively.   Entresto is $1000+ dollars per year, and the cost/benefit issues of this pricey new treatment is among the issues that have been raised.

All said, Entresto is worth considering for every patient with heart failure, and the appropriate use of this medication needs to be on a case-by-case basis.  Ask me about your treatment for heart failure and if Entresto is worth a try.