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Danuta  (Anonymous, 89.64.122.) Warszawa 2 years ago

Am I entitled to a refund for Forxiga?

Should I be reimbursed for Forxiga? Condition after prehospital SCA-VF in the course of myocardial infarction treated with balloon angioplasty of the anterior descending branch (29-01-2022). Heart failure with mildly impaired left ventricular systolic function (HFmrEF, EF40%). Hypertension. Type2 diabetes. Heart disease in the course of atherosclerosis. Congestive heart failure.

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Olga Sierpniowska Pharmacist, Editor

2 years ago

The information provided is insufficient to answer whether you should be reimbursed for Forxiga. As for the first indication, the entry shows that you will probably meet the criterion of high cardiovascular risk. You also meet the condition of diagnosed type 2 diabetes. However, here it is important whether you are a person before turning on insulin, but treated for at least 6 months with at least two drugs that lower sugar levels. A documented glycated hemoglobin score equal to or higher than 8% is necessary. As for the second criterion, it is required to reduce the ejection fraction of the left ventricle of the heart, which characterizes the LVEF parameter. It is also necessary to classify the symptoms in the NYHA class that persists despite the use of other therapy. If you have doubts whether the reimbursement is justified for you, it is best to talk about it directly with a cardiologist or diabetologist, because on the basis of your medical records they will be able to clearly verify the following criteria: Type 2 diabetes, in patients before insulin inclusion, treated with at least two oral hypoglycemic drugs for at least 6 months, with HbA1c ≥ 8% and a very high cardiovascular risk understood as: 1) confirmed cardiovascular disease, or 2) damage to other organs manifested by: proteinuria or left ventricular hyperplasia or retinopathy, or 3) the presence of 3 or more major risk factors among those listed below: -age ≥ 55 years for men, ≥60 years for women, -dyslipidemia, -hypertension, -smoking, -obesity; Chronic heart failure in adult patients with reduced left ventricular ejection fraction (LVEF≤40%) and persistent symptoms of disease in class II-IV NYHA despite the use of ACEi-based therapy (or ARB/ARNi) and beta-blockers and if indicated mineralocorticoid receptor antagonists I also attach additional studies: https://www.gdziepolek.pl/artykuly/ile-kosztuje-zycie-z-cukrzyca

Danuta (Anonymous, 89.64.122.) 2 years ago

Thank you very much for the information.

Olga Sierpniowska Pharmacist, Editor

2 years ago

For @Danuta: All the conditions in the first point or all the conditions in the second point must be met. These are two separate reimbursement indications.

Danuta (Anonymous, 89.64.122.) 2 years ago

Does this mean that if the parameters of the second point are met, the refund will be possible? Do the conditions of the first point have to be met for the second point to work?

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