Have a personal or library account? Click to login
Price and Affordability of Heart Failure Guideline Directed Medical Therapy in Venezuela: A Cross Sectional Observational Study Cover

Price and Affordability of Heart Failure Guideline Directed Medical Therapy in Venezuela: A Cross Sectional Observational Study

Open Access
|Oct 2025

References

  1. 1Averbuch T, Esfahani M, Khatib R, Kayima J, Miranda JJ, Wadhera RK, et al. Pharmaco-disparities in heart failure: a survey of the affordability of guideline recommended therapy in 10 countries. ESC Heart Fail. 2023;10(5):315263. DOI: 10.1002/ehf2.14468
  2. 2Agarwal A, Husain MJ, Datta B, Kishore SP, Huffman MD. Access to Heart Failure Medicines in Low- and Middle-Income Countries: An Analysis of Essential Medicines Lists, Availability, Price, and Affordability. Circ Heart Fail. 2022;15(4):e008971. DOI: 10.1161/CIRCHEARTFAILURE.121.008971
  3. 3Agbor VN, Ntusi NAB, Noubiap JJ. An overview of heart failure in low- and middle-income countries. Cardiovasc Diagn Ther. 2020;10(2):24451. DOI: 10.21037/cdt.2019.08.03
  4. 4Tromp J, Bamadhaj S, Cleland JGF, Angermann CE, Dahlstrom U, Ouwerkerk W, et al. Post-discharge prognosis of patients admitted to hospital for heart failure by world region, and national level of income and income disparity (REPORT-HF): a cohort study. Lancet Glob Health. 2020;8(3):e411e22. DOI: 10.1016/S2214-109X(20)30004-8
  5. 5Cruz L. Heart Failure Patients Mortality In Low Income Country Hospital From The Dominican Republic. Prospective Followup. J Card Fail. 2024;30(1):286. DOI: 10.1016/j.cardfail.2023.10.403
  6. 6Mocumbi AO. Cardiovascular Health Care in Low- and Middle-Income Countries. Circulation. 2024;149(8):5579. DOI: 10.1161/CIRCULATIONAHA.123.065717
  7. 7Tromp J, Ouwerkerk W, Teng T-HK, Cleland JGF, Bamadhaj S, Angermann CE, et al. Global disparities in prescription of guideline-recommended drugs for heart failure with reduced ejection fraction. Eur Heart J. 2022;43(23):222434. DOI: 10.1093/eurheartj/ehac103
  8. 8Heidenreich PA, Bozkurt B, Aguilar D, Allen LA, Byun JJ, Colvin MM, et al. 2022 AHA/ACC/HFSA Guideline for the Management of Heart Failure: A Report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines. Circulation. 2022;145(18):e895e1032. DOI: 10.1161/CIR.0000000000001063
  9. 9Guilliod CR, Blumer V. Abstract 12731: Implementation Barriers of Class 1a Heart Failure Guideline Recommendations in Developing Countries. Circulation. 2022;146(Suppl_1):A12731A. DOI: 10.1161/circ.146.suppl_1.12731
  10. 10Page KR, Doocy S, Reyna Ganteaume F, Castro JS, Spiegel P, Beyrer C. Venezuela’s public health crisis: a regional emergency. Lancet. 2019;393(10177):125460. DOI: 10.1016/S0140-6736(19)30344-7
  11. 11Cardiovascular disease burden [Internet] Pan American Health Organization; 2019. Available from: https://www.paho.org/en/enlace/cardiovascular-disease-burden.
  12. 12Roth GA, Dorsey H, Decleene N, Razo C, Stark B, Johnson C, et al. The global burden of heart failure: a systematic analysis for the Global Burden of Disease Study 2021. Eur Heart J. 2023;44(Supplement_2):ehad655.876. DOI: 10.1093/eurheartj/ehad655.876
  13. 13Bryce Stevens LP, Verdian L, Tomlinson J, George A, Parejo JA. La carga economica de las condiciones cardiacas en Venezuela. Med Interna (Caracas). 2017;33(1):4250.
  14. 14Vladimir Fuenmayor Ojeda RD, Diaz J, Adrian JAP. Insuficiencia Cardiaca Aguda: Evaluacion de la mortalidad posterior al egreso hospitalario. Med Interna (Caracas). 2018;34(3):16171.
  15. 15Estrategias para Incrementar el Control de la Hipertensión en Venezuela: Proyecto Hipertension Venezuela; 2020. Available from: https://hipertensionvenezuela.com/.
  16. 16Ciapponi A, Alcaraz A, Calderón M, Matta MG, Chaparro M, Soto N, et al. Burden of Heart Failure in Latin America: A Systematic Review and Meta-analysis. Rev Esp Cardiol (Engl Ed). 2016;69(11):105160. DOI: 10.1016/j.rec.2016.04.054
  17. 17Measuring medicine prices, availability, affordability and price components: World Health Organization and Health Action International; 2008. Available from: https://syntheticdrugs.unodc.org/uploads/syntheticdrugs/res/library/access_html/WHO_-_Measuring_medicine_prices_availability_affordability_and_price_components.pdf.
  18. 18Farmacias CVd. Available from: https://cavefar.org.ve/.
  19. 19Se recupera el salario privado pero disminuye el publico para el tercer trimestre de 2023: Observatorio Venezolano de Finanzas; 2023. Available from: https://observatoriodefinanzas.com/.
  20. 20Heidenreich P. An Underappreciated Risk Factor for Heart Failure—Financial Toxicity. JAMA Netw Open. 2024;7(3):e241403e. DOI: 10.1001/jamanetworkopen.2024.1403
  21. 21Srivastava PK, DeVore AD, Hellkamp AS, Thomas L, Albert NM, Butler J, et al. Heart Failure Hospitalization and Guideline-Directed Prescribing Patterns Among Heart Failure With Reduced Ejection Fraction Patients. JACC: Heart Failure. 2021;9(1):2838. DOI: 10.1016/j.jchf.2020.08.017
  22. 22Satheesh G, Dhurjati R, Alston L, Tesfay F, Pant R, Bahiru E, et al. Use of Guideline-Recommended Heart Failure Drugs in High-, Middle-, and Low-Income Countries: A Systematic Review and Meta-Analysis. Glob Heart. 2024;19(1):74. DOI: 10.5334/gh.1355
  23. 23Mills A. Health Care Systems in Low- and Middle-Income Countries. N Engl J Med. 2014;370(6):5527. DOI: 10.1056/NEJMra1110897
  24. 24Peters DH, Garg A, Bloom G, Walker DG, Brieger WR, Rahman MH. Poverty and access to health care in developing countries. Ann N Y Acad Sci. 2008;1136:16171. DOI: 10.1196/annals.1425.011
  25. 25Orach CG. Health equity: challenges in low income countries. Afr Health Sci. 2009;9 Suppl 2(Suppl 2):S4951.
  26. 26Joseph S, Panniyammakal J, Abdullakutty J, Sujithkumar S, Vaikathuseril LJ, Joseph J, et al. The Cardiology Society of India-Kerala Acute Heart Failure Registry: poor adherence to guideline-directed medical therapy. Eur Heart J. 2021. DOI: 10.1093/eurheartj/ehab793
  27. 27PERSONAS REFUGIADAS Y MIGRANTES VENEZOLANAS: R4V Plataforma de coordinacion interagencial para refugiados y migrantes de Venezuela; 2024. Available from: https://www.r4v.info/es/refugiadosymigrantes.
  28. 28Zerpa O. Migration of physicians and keys to success. Clin Dermatol. 2020;38(5):5238. DOI: 10.1016/j.clindermatol.2020.05.007
  29. 29Encuesta Nacional de Hospitales, Informe Anual Medicos por la Salud: Medicos por la Salud; 2023 Available from: https://www.encuestanacionaldehospitales.com/boletines2023.
  30. 30Orozco MaKK. Money Transfers to Venezuela: Remittance Flows Amidst Evolving Foreign Exchange. Washington DC Inter-American Dialogue. 2020. Available from: https://thedialogue.org/analysis/money-transfers-to-venezuela-remittance-flows-amidst-evolving-foreign-exchange
  31. 31Datta Namita RC, Sunamika S, Clara S, Nadina I, Simachew NN, Mpumelelo N, Luke K. Working Without Borders: The promise and peril of online gig work. World Bank Publications. 2023. Available from: https://openknowledge.worldbank.org/entities/publication/ebc4a7e2-85c6-467b-8713-e2d77e954c6c
  32. 32Nieto-Martínez R, González-Rivas JP, Ugel E, Duran M, Dávila E, Constantino R, et al. Cardiometabolic risk factors in Venezuela. The EVESCAM study: a national cross-sectional survey in adults. Prim Care Diabetes. 2021;15(1):10614. DOI: 10.1016/j.pcd.2020.07.006
  33. 33ENCOVI 2022. Radiografia de la vulnerabilidad social de venezuela y propuestas de politicas publicas Encuesta Nacional de Condiciones de Vida (ENCOVI). Universidad Catolica Andres Bello, Instituto de Investigaciones Economicas y Sociales; 2023. Available from: https://www.proyectoencovi.com/.
  34. 34ENCOVI 2023. Radiografia de la vulnerabilidad social de venezuela y propuestas de politicas publicas Encuesta Nacional de Condiciones de Vida (ENCOVI). Universidad Catolica Andres Bello, Instituto de Investigaciones Economicas y Sociales; 2024. Available from: https://www.proyectoencovi.com/.
  35. 35Burki TK. Ongoing drugs shortage in Venezuela and effects on cancer care. Lancet Oncol. 2017;18(5):578. DOI: 10.1016/S1470-2045(17)30258-9
  36. 36Plan Maestro para el fortalecimiento de la respuesta al VIH, la tuberculosis y la malaria en la República Bolivariana de Venezuela desde una perspectiva de salud pública: Organizacion Panamericana de la Salud, Organizacion Mundial de la Salud, Gobierno Bolivariano de Venezuela, ONUSIDA; 2018. Available from: https://reliefweb.int/report/venezuela-bolivarian-republic/plan-maestro-para-el-fortalecimiento-de-la-respuesta-al-vih-la.
  37. 37HEARTS Technical package for cardiovascular disease management in primary care: Access to essential medicines and technology. Available from: https://www.paho.org/en/hearts-americas/hearts-americas-technical-package.
  38. 38Ruiz R, Strasser-Weippl K, Touya D, Herrero Vincent C, Hernandez-Blanquisett A, St. Louis J, et al. Improving access to high-cost cancer drugs in Latin America: Much to be done. Cancer. 2017;123(8):131323. DOI: 10.1002/cncr.30549
  39. 39Urias E, Ramani SV. Access to medicines after TRIPS: Is compulsory licensing an effective mechanism to lower drug prices? A review of the existing evidence. J Int Bus Policy. 2020;3(4):36784. DOI: 10.1057/s42214-020-00068-4
  40. 40International A. NGOS in Venezuela at risk Online: Amnesty International; 2023. Available from: https://www.amnesty.org.uk/urgent-actions/venezuela-ngos-risk.
DOI: https://doi.org/10.5334/gh.1474 | Journal eISSN: 2211-8179
Language: English
Submitted on: Nov 20, 2024
Accepted on: Sep 11, 2025
Published on: Oct 9, 2025
Published by: Ubiquity Press
In partnership with: Paradigm Publishing Services
Publication frequency: 1 issue per year

© 2025 Karim J. Gebran-Chedid, Diana De Oliveira-Gomes, Gabriela Lombardo, Maria Carolina Bacci-Padron, David A. Forero-Peña, published by Ubiquity Press
This work is licensed under the Creative Commons Attribution 4.0 License.