Please described your clinical practice, how many patient do you treat for symptomatic chronic heart failure? And how many have you prescribed Verquvo for?

Can you please discuss your experience with Verquvo in the patients you have prescribe it for?

Where would you rate your excitement of this drug on a scale from 1 to 10?

Please describe the treatment landscape and the treatment algorithm for the heart failure setting, in symptomatic patients with ejection fraction <45%.

Verquvo's approved indication is following hospitalization for HF or the need for IV diuretics.  Other than hospitalization what is the situation where a patient would need IV diuretics.
How common are either scenario in heart failure patients?

Given the existence of multiple treatment options including several branded drugs, how does Verquvo fit into the landscape?
Around 15% of the patients in the Phase 3 VICTORIA trial were on Entresto, and this was before SGLT2 inhibitors were approved.  Is the data still relevant in your mind?
Does use of Verquvo come down to a choice between SGLT2 vs. Verquvo as add-on to Entresto?  How do you make that decision?   Or, is it only as an add-on after SGLT2 etc and the patient is still symptomatic?  
Do you strictly use the 45% cut off for ejection fraction?

The trial used a step up dosing regimen.  Is this how you are using the drug?  Does this factor into your decision between this and other agents?  

In terms of the patients you have treated with Verquvo so far, please describe them and what category they fall under.  Do you anticipate prescribing for a similar "type" of patient going forward?  Are you expanding your use, contracting?  Staying the same?

How has the patient benefit been so far, if you have followed these patients long enough yet.  Is it preventing hospitalizations as you see it?

How has accessibility been so far for getting patients this drug?  Talk about barriers and challenges to this, including multiple branded drugs these patients receive

Some experts believe the existing trial data is no longer relevant due to its timing (mostly out of the company's control) and the lack of universal use of Entresto in the trial and therefore they only use this 4th line.  Do you agree/disagree with this view, and if so can you state the rationale behind your stance.
Do you believe verquvo is better/worse/same as a SGLT2 in this setting?  Or no way to know? 

How do you view the Verquvo phase 3 clinical trial data (VICTORIA trial) and put in context of the treatment landscape?  
Study was positive on the composite endpoint but seemed to be driven by reduced hospitalizations and possibly not by death from cardiac causes.  No difference on death from all causes.   What is your view on the patient benefit from this treatment and its magnitude?