The Burden of Heart Failure**
Heart failure is a chronic, clinical syndrome resulting from impairment of the heart’s ability to pump blood. If untreated, it will lead to water and salt retention, and volume overload, each contributing to peripheral edema, fatigue and difficulty breathing. Acute Decompensated Heart Failure (ADHF) refers broadly to new or worsening signs and symptoms of heart failure that progresses rapidly and demands unscheduled medical care or hospital evaluation.
Heart failure affects 6.5 million adults in the United States and is expected to grow to greater than 8 million by 2030. In the Unites States, heart failure was associated with direct medical costs of $21 billion dollars in 2012 and is projected to increase three-fold to $53 billion dollars by 2030. Heart failure consumes 33% of the total Medicare dollars spent annually and accounts for 41% of all Medicare hospital admissions and 53% of all Medicare readmissions.
Worsening heart failure is one of the most common causes of hospital admissions in patients over 65 with at least 1 – 2 million hospitalizations in the United States annually. The average length of stay for an admission for worsening heart failure is 5.2 days at a cost of $11,840 per hospital admission and $15,067 for a readmission within 30-days of initial discharge.
The Current Management of Heart Failure
ADHF is the primary cause for patient admission to the acute care setting among adult patients with heart failure. The primary intervention upon hospital admission for ADHF is to reduce fluid overload through a process call diuresis, or increased urine output. The average heart failure patient loses 2.2 gallons (8.4 liters) of body fluid during standard treatment. Water is heavy and patients lose on average 15 pounds over the 5 – 6 day hospital stay.
Fluid build-up is a relatively slow process which may take up to three weeks. The patient may slowly begin to recognize the worsening symptoms and increase in body weight. Fluid overload is frequently accompanied by gut edema, which isn’t obvious to the patient and can reduce oral drug absorption. Therefore, intravenous diuretics in the hospital are typically required for the management of excessive fluid overload to break the downward spiral of decompensation to restore oral absorption.
Standard of Care in Decompensated HF
The majority of patients with heart failure do not receive any advanced procedure while in the hospital. They are just there to receive intravenous furosemide to reduce fluid overload. It is estimated that about half the patients could finish the treatment at home after a short 1-2 day stay.
Transforming the Treatment Paradigm
Furosemide delivered subcutaneously—just under the skin instead of through an IV— would offer a new option to clinicians treating patients with heart failure. It has the potential to keep patients out of the hospital, facilitate early discharge and prevent readmissions, while significantly reducing risks and costs. It represents the first major treatment advance for fluid overload in heart failure in more than half a century.
Learn more about how scPharmaceuticals is developing subcutaneous furosemide in combination with its proprietary sc2Wear™ Infusor.
**CAUTION: Investigational Product – Limited by Federal Law to Investigational Use.