Observational studyGlobal heart2025
Price and Affordability of Heart Failure Guideline Directed Medical Therapy in Venezuela: A Cross Sectional Observational Study.
Observational study in Global heart, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
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Corrections and comments
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Authors and funding
5 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Background: Heart failure (HF) impacts over 56 million people worldwide, with significantly higher mortality rates in low and low-middle-income countries (LIC/LMICs). Despite the effectiveness of guideline-directed medical therapy (GDMT) for HF with reduced ejection fraction (HFrEF), its use remains limited in LIC/LMICs due to limited availability and affordability. These barriers are particularly pressing in Venezuela's context, as the country faces an ongoing crisis. Objective: Describe price and affordability of HF Guideline Directed Medical Therapy at optimal dosages in Venezuela. Methods: We conducted a cross-sectional analysis from December 2023 to January 2024, surveying prices of HF GDMT medications across 13 major pharmacy networks in Venezuela. Medications analyzed included ACE inhibitors (ACEi), angiotensin receptor blockers (ARB), beta-blockers (BB), mineralocorticoid receptor antagonists (MRA), angiotensin receptor-neprilysin inhibitors (ARNI), and sodium-glucose co-transporter 2 inhibitors (SGLT2i). Affordability was defined and calculated using the World Health Organization/Health Action International (WHO/HAI) methodology, comparing the median costs of one month of HF GDMT at optimal dosages to the lowest-paid government worker's (LPGW) daily wages. Other comparisons of price affordability were made against the mean daily salary of managers, professional and non-professional workers in the country. Results: The most expensive medication regime for HF in Venezuela was ARNI-based GDMT with a median monthly cost of 393.81USD, followed by ARB-based GDMT and ACEi-based GDMT costing $100.88USD and $82.23USD respectively. meaning LPGW and elderly receiving retirement stipends would need between 506 to 2421 paid work days to cover one month of treatment at optimal dosages. Conclusion: Based on the WHO/HAI methodology all HF GDMT regimens were deemed unaffordable in Venezuela. Similar affordability challenges exist in other LIC/LMICs countries highlighting the need for global advocacy and policy action to address financial barriers to access guideline-based heart failure care.
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