BRIEF RESEARCH REPORT article
Front. Cardiovasc. Med.
Sec. Heart Failure and Transplantation
Volume 12 - 2025 | doi: 10.3389/fcvm.2025.1633435
This article is part of the Research TopicTransforming Care in Heart Failure and Cardiomyopathies: Emerging Insights and TreatmentsView all 4 articles
Eligible Patients with Heart Failure Prescribed Versus Not Prescribed Vericiguat in the United States
Provisionally accepted
Stephen J Greene1*
Catelyn R Coyle2Lucy N Hancock3
Kathryn W Tebbs3
Sophie Barlow3Andra S Stevenson2
Engels Obi4- 1Duke Clinical Research Institute, School of Medicine, Duke University, Durham, United States
- 2Merck & Co., Inc, Rahway, United States
- 3Adelphi Real World, Bollington, United Kingdom
- 4Merck & Co Inc, Rahway, United States
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Aims: This study compared characteristics of patients with heart failure (HF) prescribed vericiguat versus eligible patients with HF not prescribed vericiguat, to identify factors associated with vericiguat use in real-world settings. Methods: We analysed 2022-2023 Adelphi HF cross-sectional survey from United States physicians and their adult patients. Patients prescribed vericiguat were compared with patients eligible for but not prescribed vericiguat. Vericiguat eligibility was defined as ≥1 prior HF hospitalization at any time, ejection fraction (EF) <45%, and no stage 5 chronic kidney disease or need for dialysis. Both cohorts were compared descriptively, and logistic regression used to identify factors associated with vericiguat non-use. Results: Overall, 93 physicians reported data on 228 patients with HF (mean age [SD]: 66.8 years [11.8], 65.7% male, 60.1% White), with 98 patients prescribed vericiguat and 130 patients eligible but not prescribed vericiguat. Patients eligible but not prescribed vericiguat had more comorbid hypertension (62.3% vs 45.9%), hyperlipidemia (52.3% vs 34.7%), and lower EF (mean [SD]: 34.7% [5.8%] vs 41.7% [9.6%]), all p<0.05. For every 1% increase in EF above 38%, odds of being prescribed vericiguat increased by 44% (Odds Ratio [SD]: 1.44 [1.28,1.63]; p<0.05). Conclusions: Among patients with HF in contemporary US clinical practice, patients prescribed vericiguat have distinct demographic and clinical profiles compared to eligible patients not prescribed vericiguat. Lower EF was independently associated with higher likelihood of vericiguat non-prescription. Future research should confirm these findings and explore whether subgroups of eligible patients less likely to be prescribed vericiguat may benefit from targeted implementation initiatives.
Keywords: vericiguat, Heart Failure, eligibility, United States, ejection fraction
Received: 22 May 2025; Accepted: 18 Jul 2025.
Copyright: © 2025 Greene, Coyle, Hancock, Tebbs, Barlow, Stevenson and Obi. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Stephen J Greene, Duke Clinical Research Institute, School of Medicine, Duke University, Durham, United States
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