With the CDC estimating that about 5.7 million US adults experience heart failure, it’s important to understand treatment options carefully. Medications like Entresto may be prescribed by your doctor if you have symptoms of heart failure.

Common Types of Heart Failure                      

The left and right side of your heart function in tandem with one another, but each side serves distinctly different purposes. The right side of the heart supplies the lungs, which provides blood with a fresh oxygen supply that is then pumped to the rest of the body via the left side of the heart. One or both sides can experience symptoms of heart failure.

Heart failure in the left side is the most common and occurs when the left ventricle’s ability to pump blood to the body malfunctions. This causes a back-up of blood in the lungs. Symptoms of this include feeling short of breath or experiencing fluid build-up in the chest cavity and lungs.

Right-sided heart failure can occur as a side effect of different medical conditions, like lung disease, but it is often triggered by left-sided heart failure. While this type of heart failure also results in fluid build-up, it happens in the abdomen and lower extremities.

Other types of heart failure include diastolic and systolic failure. In diastolic heart failure, the muscle tissue of the heart is stiffer than it would normally be. This complicates the volume of blood the heart can pump effectively, which means circulation throughout the rest of the body is also compromised.

When the heart muscle does not contract as it should, it’s called systolic failure. A weak or enlarged heart is commonly associated with this type of heart failure and is shown to be more common in men that it is in women.

Understanding How Entresto Works

Sold under the brand name of Entresto, this medication’s combination of sacubitril, a common blood pressure medicine, and valsartan, an angiotensin II receptor blocker, works to keep blood vessels dilated and lower sodium levels in the blood.

Helping to keep blood pressure low and blood vessels from narrowing may prevent a person with chronic heart failure from experiencing certain serious and life-threatening symptoms. This medication is given to patients whose heart failure results in an enlarged and weakened heart, so it may not be suitable for all types of heart failure.

Blood pressure medications like Entresto may not be suitable for those with kidney disease or a history of kidney issues. Other medications can also impair Entresto’s effectiveness. Make sure your doctor is aware of your medical history and any current prescription medications, over-the-counter medications and supplements you take.

Treatment with Entresto typically follows a dosage plan that starts a patient off on a small amount before increasing the dose to the recommended amount. The medication is a pill that is typically taken twice a day by mouth. Anyone who may struggle to take medications orally should talk to their doctor or pharmacist before cutting or crushing the pill to make sure this does not result in adverse effects.

Medicare Coverage for Entresto

Original Medicare insurance, also known as Part A and Part B Medicare insurance, does not cover costs associated with most prescription drugs taken at home. Medicare does contract prescription drug services out to third-party insurers who may offer stand-alone Part D prescription drug plans or Medicare Advantage plans that include Part D coverage as a packaged benefit alongside the Part A and Part B coverage they provide.

Because these plans are maintained by private insurers, coverage for certain medications can be different depending on the provider and the location they serve. Each insurer creates their own formulary, or list of covered drugs, and assigns each medication a tier related to the cost of that medication. Formularies and tiers are not subject to standardized regulation, so Medicare beneficiaries must check with a plan to confirm if Entresto is covered and under which tier.

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