NICE (UK) positive for Jardiance for treating chronic heart failure with reduced ejection fraction.- Eli Lilly + Boehringer

Why the committee made these recommendations ? People with heart failure with reduced ejection fraction may have symptoms that are not controlled well enough despite being on the most appropriate (optimised) standard care. Standard care includes an ACE inhibitor or an ARB, with a beta blocker and, if tolerated, an MRA. Then, if symptoms continue on this, people may be offered sacubitril valsartan with a beta blocker and, if tolerated, an MRA. Evidence from a clinical trial shows that empagliflozin plus standard care reduces the risk of dying from cardiovascular causes compared with placebo plus standard care. It also shows that it reduces the likelihood of hospitalisation for heart failure. There are no trials directly comparing empagliflozin with the most appropriate comparator, dapagliflozin. However, an indirect comparison suggests that empagliflozin is likely to be similar to dapagliflozin in reducing the risk of dying and the likelihood of hospitalisations for heart failure. The cost-effectiveness estimates for empagliflozin are within what NICE normally considers an acceptable use of NHS resources. So empagliflozin is recommended.