CCG Briefing on Sacubitril Valsartan (Entresto®) NICE Technology Appraisal Guidance TA388

11th July 201621st February 2017

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This briefing is designed to inform CCGs of the implications of NICE TAG 388 Sacubitril valsartan for treating symptomatic chronic heart failure with reduced ejection fraction.

Sacubitril valsartan is recommended as an option for treating symptomatic chronic heart failure with reduced ejection fraction, only in people:

with New York Heart Association (NYHA) class II to IV symptoms and
with a left ventricular ejection fraction of 35% or less and
who are already taking a stable dose of angiotensin-converting enzyme (ACE) inhibitors or angiotensin II receptor-blockers (ARBs).

Treatment with sacubitril valsartan should be started by a heart failure specialist with access to a multidisciplinary heart failure team.

This technology is commissioned by clinical commissioning groups (CCGs). Providers are NHS hospital trusts and GPs in primary care.

Sacubitril valsartan for treating symptomatic chronic heart failure falls within the programme budgeting category 9: problems of circulation.

Because sacubitril valsartan was made available in the NHS through the early access to medicines scheme, NHS England has indicated that this guidance will be implemented 30 days after final publication, as opposed to the usual 90 days. Sacubitril valsartan is the first drug commissioned by CCGs to be approved under the early access to medicines scheme.

This therefore means that CCGs have been obliged to fund this treatment, where a clinician and patient feel it is the correct choice for them, from the end of May 2016.

This should therefore now be incorporated into local formularies, without further review of the evidence.