Glenmark Pharmaceuticals Ltd. (Glenmark) launched the sacubitril + valsartan tablets in India, for the treatment of heart failure. Marketed under the brand name `Sacu VTM', it must be taken twice daily under doctor's prescription. Its approved indication is to reduce the risk of cardiovascular related deaths and hospitalisations for patients with chronic heart failure (NYHA class IIIV) with reduced ejection fraction (HFrEF).

The sacubitrilvalsartan combination belongs to the class ARNI (Angiotensin receptor neprilysin inhibitor). These molecules have two therapeutic targets in the treatment of heart failure: 1) the natriuretic peptide (NP) system for sacubitril and the 2) Renin Angiotensin System (RAS) for valsartan. The use of sacubitril + valsartan has an established role in treatment of patients with heart failure with reduced ejection fraction (HFrEF) and has been endorsed by the latest heart failure treatment guidelines in Europe4 and the USA5.

Glenmark's Sacu VTM is priced at INR 19 per tablet for a dose of 50mg (sacubitril 24mg + valsartan 26mg), INR 35 per tablet for a dose of 100mg (sacubitril 49mg + valsartan 51mg), and INR 45 per tablet for a dose of 200mg (sacubitril 97mg + valsartan 103mg). According to IQVIATM sales data (SSA MAT Dec. 2022) for the 12 month period ending December 2022, the total cardiology market is estimated to be INR 207,300 million; with an annual growth of 7.7% against the corresponding period last year (MAT Dec.

2021). The ARNI market (sacubitril + valsartan) is estimated to be INR 5,140 million; with an annual growth of 37.2%.