Impact of the COVID-19 pandemic on prescription of sacubitril/valsartan in Italy

Eur J Heart Fail. 2022 May;24(5):855-860. doi: 10.1002/ejhf.2490. Epub 2022 Mar 31.


Aims: The present study sought to examine the effect of the COVID-19 pandemic and lockdown measures on the prescription of sacubitril/valsartan in patients with heart failure (HF) in Italy.

Methods and results: Data from Italian Medicines Agency (AIFA) monitoring registries were analysed. The sacubitril/valsartan monitoring registry is based on 6-month prescriptions. A monthly aggregation on new activations throughout the observational period was computed. From March to December 2020, the initiation of new HF patients on sacubitril/valsartan decreased by nearly 40% with prescriptions dropping to values similar to 2018 when the registry was still operated off-line. A slight increase in prescriptions was observed after the lockdown measures were lifted, but prescriptions remained constantly below the pre-lockdown period.

Conclusion: A marked and worrisome decline during the COVID-19 pandemic in the activation of a life-saving treatment such as sacubitril/valsartan was observed. This decline was clearly linked to the lockdown measures instated to counteract the COVID-19 pandemic. Upcoming studies should analyse the occurrence of new cases of HF as well as the severity of patients admitted to hospitals and their mortality compared to pre-pandemic levels.

Keywords: COVID-19; Heart failure; Registry; Sacubitril/valsartan.

MeSH terms

  • Aminobutyrates / therapeutic use
  • Angiotensin Receptor Antagonists / therapeutic use
  • Biphenyl Compounds
  • COVID-19* / epidemiology
  • Communicable Disease Control
  • Drug Combinations
  • Heart Failure* / drug therapy
  • Heart Failure* / epidemiology
  • Humans
  • Pandemics
  • Prescriptions
  • Stroke Volume / physiology
  • Tetrazoles / therapeutic use
  • Treatment Outcome
  • Valsartan


  • Aminobutyrates
  • Angiotensin Receptor Antagonists
  • Biphenyl Compounds
  • Drug Combinations
  • Tetrazoles
  • sacubitril
  • Valsartan