We have an increasing number of reports on guidelines for the use of flosins, not only in patients with diabetes and nephrology problems, but also in cardiac patients. How do you assess the importance of flosins therapy in your patients, especially those with heart failure, with preserved ejection fraction?
At the moment, we are no longer wondering why the patient has phlozin, rather why the patient did not get phlozin. This is indeed a drug that does not adversely affect other diseases. Such drugs are scarce and we often have to choose the lesser of two evils. We want to help the disease entity that comes to the forefront in terms of the patient's problems, but we have to take into account that in some other diseases there may be worsening. There is no such thing with the phlozines. They have a nephroprotective effect, improve glycemic tolerance, and are also effective in the treatment of heart failure, not only heart failure with reduced ejection fraction, but also heart failure with preserved ejection fraction, and this is a completely different disease entity. Most importantly, the studies that confirmed the efficacy of flosins used very simple inclusion criteria. If we want our patients to benefit from this treatment option, we should not overextend the definition of heart failure with preserved ejection fraction, because it will be more difficult to catch those patients who will be able to benefit from this treatment.
A very important issue is related to the purchase of medicines. The problem mainly affects seniors, whose budget is often very limited. What could make it easier for them to access these medicines?
We have reimbursement at the moment for patients with reduced ejection fraction, that is, those with an ejection fraction of less than 40 percent. Of course, this is only a portion of the population that can benefit from this treatment. Reimbursement applications have been submitted for a group of patients with preserved or mildly reduced ejection fraction. However, we need to realize that although at the moment flozin in heart failure patients with reduced ejection fraction is the standard of treatment, some patients cannot afford to buy the drug after reimbursement. These are often patients with multimorbidity who need to take multiple medications anyway. I'm thinking especially of the senior population over the age of 75. I think the decision to include flozone in the list of free drugs for seniors would be something that would help this group of patients benefit from modern and highly effective treatment.
