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Objectives

Sacubitril/valsartan, an angiotensin receptor/neprilysin inhibitor (ARNi), is one of the newest drug classes with efficacy in improving heart failure (HF) outcomes. We aimed to determine the longitudinal adherence patterns of ARNi among Medicare beneficiaries with HF and to identify factors associated with ARNi adherence.

Methods

In a 15% sample of 2015-2018 Medicare beneficiaries, we identified HF patients who initiated ARNi and were followed up for 1 year. We calculated the proportion of days covered (PDC) of ARNi for each patient every 30 days over the first year following ANRi initiation. A group-based trajectory model (GBTM) was applied to identify patient groups with similar adherence patterns during the follow-up year. We constructed to identify factors associated with the adherence trajectories membership.

Results

Among 9475 eligible beneficiaries (mean±sd age 77±7 years, 34% female …