The Surrey Heartlands Integrated Care System Area Prescribing Committee (APC) approves dapagliflozin as recommended by NICE TA902 as an option for treating chronic heart failure with preserved or mildly reduced ejection fraction in addition to standard care.

Dapagliflozin for this indication will be considered as BLUE on the traffic light system (treatment should be initiated or recommended by a heart failure specialist in patients with a formal diagnosis of heart failure with preserved or moderately reduced ejection fraction as per NICE guideline on Chronic Heart Failure in adults)

Heart Failure specialist definition as per current BLUE information sheet for dapagliflozin/empagliflozin in HFrEF:

 • Cardiology consultant, specialist, or registrar

 • Heart failure specialist nurse

 • GP with a specialist interest in heart failure or GP cardiologist

 • General physician with heart failure expertise

 • Renal physician

 PLEASE NOTE THE CHANGE IN ADVICE:

The Surrey Heartlands Integrated Care System Area Prescribing Committee has agreed a BLUE information sheet for empagliflozin and dapagliflozin for Adult Heart Failure with reduced ejection fraction (HFrEF) (in line with NICE TA773 and NICE TA679), and a place in therapy document for these treatments in patients with Heart Failure.

The specialist should either:

• provide a minimum of one month supply OR
• provide advice and guidance and recommend to the patient’s primary care prescriber to initiate prescribing

DO NOT INITIATE dapagliflozin in patients with type I diabetes and heart failure as this is off label use (outside of license)

NOTE - 

Dapagliflozin for symptomatic heart failure (other than adult symptomatic chronic Heart Failure with reduced ejection fraction) has not yet been assessed for formulary status.

This is a license extension that has not yet been evaluated by NICE or the Surrey Heartlands ICS Area Prescribing Committee (APC). As such, advice regarding safety, effectiveness (including cost-effectiveness) and its place in therapy is yet to be determined. It is recommended that clinicians contact their medicines management team for further information and advice before prescribing this drug for this extended indication.

NICE are due to publish further guidance on Dapagliflozin in June 2023 and this will be considered by the APC within NICE timelines