Pfizer’s
heart pill Inspra has gained a new licence in the UK to reduce the risk of
death in patients with heart failure. Inspra (eplerenone) is already indicated to treat patients with heart
failure after a recent heart attack, alongside standard therapy.
This new licence, which is available to the NHS this week, is to reduce the
risk of cardiovascular mortality and morbidity in adult patients with chronic
heart failure, and left ventricular systolic dysfunction. The drug costs £1.53 per day, and around £42 for a month’s worth of
tablets. NICE will not need to assess the drug’s cost effectiveness as it is
already recommended at this price for its first licence.
Martin Cowie, professor of cardiology at Imperial College and consultant
cardiologist at the Royal Brompton Hospital, London, said: “Patients with
chronic heart failure have a shorter life expectancy than patients with the
most common types of cancer and can require frequent admission to hospital.
“These admissions account for the majority of the costs associated with
treating chronic heart failure. New strategies that have the potential to
reduce these costs as well as extending patients’ lives are particularly
welcome during these times of increased financial pressure.
The drug made Pfizer $195 million last year, an increase of 24% on its 2010
sales. Over 875,000 people in the UK suffer from heart failure and despite current
standard therapy, patients continue to experience frequent admissions to hospital
and reduced life expectancy, with one in three patients dying within a year of
diagnosis.
Frequent hospitalisations can be due to exacerbations of the condition,
which are thought to lead to progressive decline in cardiac function. These hospital admissions can also place a considerable financial burden on
the NHS, as patients stay on average 11 days in hospital.
The firm said the drug is a cost effective use of the NHS’ money as it can
cut hospital admissions, and has an incremental cost per QALY gained of
£3,534. This is far below the £20,000 - £30,000 threshold typically viewed by NICE
as representing good value for money.
Inspra is an aldosterone antagonist and helps prevent salt retention, which
can cause the body to retain fluids. Reducing fluid build-up eases shortness of breath, reduces fatigue and
lessens swelling.
Current treatments include diuretics, nitroglycerine and ACE inhibitors,
which are all used to reduce symptoms and deaths in heart-failure patients.