Financial Toxicity of Medical Management of Heart Failure

Optimal medical management of heart failure (HF) improves quality of life, decreases mortality, and decreases hospitalizations. Cost may limit access and adherence to HF medications, especially angiotensin receptor-neprilysin inhibitors and sodium/glucose co-transporter 2 inhibitors. Patients’ experiences with HF medication cost include financial burden, financial strain, and financial toxicity. While there has been research studying financial toxicity in patients with some chronic diseases, there are no validated tools for measuring financial toxicity of HF, and very few data on the subjective experiences of patients with HF and financial toxicity. Strategies to reduce HF-associated financial toxicity include systemic changes to minimize cost-sharing, optimize shared-decision making, implement policies to lower drug costs, broaden insurance coverage, and utilize financial navigation services and discount programs. Clinicians may also improve patient financial wellness through various strategies in routine clinical care. Future research is needed to study financial toxicity and associated patient experiences for HF.