Transthyretin-mediated amyloidosis (ATTR) is rare, progressive, and still undiagnosed.[1] At a featured session during Becker’s 16th Annual Meeting, a panel of cardiology and pharmacy leaders outlined both the scale of the problem and a practical playbook for health system administrators looking to close the gap.
The session, titled “Better together: How pharmacy and cardiology can partner to elevate complex cardiac care,” was moderated by Ginger Biesbrock, DSc, PA-C, senior vice president of the National Heart and Vascular Service Line at Advocate Health (Charlotte, N.C.). Panelists included Nitasha Sarswat, MD, director of the Multi-Institutional Amyloid Center of Excellence at University of Chicago Medicine, and Ghalib Abbasi, PharmD, director of system pharmacy informatics and virtual pharmacy, and director of Houston Methodist Specialty Pharmacy at Houston Methodist.
Here are three key takeaways from the session.
Note: Quotes have been lightly edited for length and clarity.
1. The diagnosis gap is large — and costly
Data presented at the session painted a stark picture: ATTR cardiomyopathy (ATTR-CM) affects an estimated 150,000 or more patients in the U.S., fewer than half are diagnosed and fewer than half of those are treated.2-7 Dr. Biesbrock noted patients often wait more than four years for a diagnosis and treatment, during which time undetected disease drives significantly higher rates of hospitalization, ED visits and cardiac procedures — and impacts CMS quality metrics, including in-hospital mortality and readmissions.8
“These are patients that deserve at this point better care than what we’ve historically been able to do,” Dr. Biesbrock said.
2. Identification starts with a physician champion and EHR infrastructure
Closing the diagnosis gap requires both human leadership and technology. “The number one thing in our system has been having a disease state leader, somebody like myself who’s passionate about the disease, and it’s education, education, education,” Dr. Sarswat said.
Raising awareness across specialties — orthopedics, geriatrics, neurology and beyond — is essential to capture patients who would otherwise be missed.
On the technology side, Dr. Abbasi described a risk-scoring model Houston Methodist incorporated within its EHR to flag high-risk patients based on clinical criteria, automatically generating referrals for those above a score threshold. “Amyloid programs cannot go anywhere without good partnership with your informatics group in your institution,” he said.
Dr. Biesbrock urged administrators to assess what their organizations are currently doing in the amyloid space, identify their physician champions and evaluate how effectively they are socializing and building awareness around the disease.
3. Pharmacy-cardiology partnership is the operational engine, and the business case is clear
Diagnosing patients is only the first challenge. Managing complex ATTR therapies requires pharmacy involvement from the start. Dr. Sarswat noted that at both institutions where she practices, she knows her specialty pharmacy colleagues by first name because they are in close, frequent contact. The partnership covers everything from prior authorizations to infusion center workflows to grant assistance for patients.
For administrators looking to build or strengthen this infrastructure, Dr. Biesbrock outlined a clear action plan: use available data to quantify the patient population, map where patients are being managed and identify those who are under-managed. That process converts a clinical challenge into a business case. The right stakeholders to have at the table, she noted, include finance, cardiology leadership, pharmacy leadership, IT leadership and data governance.
“When you can get good quantifiable data out of your system, that creates a very strong way to engage those that are decision makers around releasing budgets and funding for infrastructure for these things,” Dr. Biesbrock said.
1. Laires et al. Open Heart. 2025;12(2):e003781.
2. Data on file. Alnylam Pharmaceuticals, Inc.
3. U.S Census Bureau. np2023-t1. Accessed April 24, 2026. https://www2.census.gov/programs-surveys/popproj/tables/2023/2023-summary-tables/.
4. Lindmark et al. ESC Heart Fail. 2021;8(1):745-749.
5. Jacobson et al. Amyloid; 2015.22(3):171-174.
6. Jacobson et al. Am J Cardiol. 2011;108(3):440-444.
7. Quarta et al. N Engl J Med. 2015;372(1):21-29.
8. Arora et al. J Am Coll Cardiol CardioOnc. 2020;2(5):710-718.
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