OBJECTIVES

Stable Angina is a chronic condition with debilitating effects that impresses the patients' quality of life harmfully. Patients with the history of stable angina have more experiences in cardiovascular events compared with general population. Second line treatments are suggested in the patients suffering from persistent angina, beside the use of the standard of care (SOC). This study aimed to conduct the Cost-Utility evaluation and Budget Impact Analysis of adding-on Ranolazine to the SOC compared with adding-on Nicorandil to the SOC in the treatment of refractory stable angina in the Iranian setting.

METHODS

An excel-based Markov cohort model with 12 cycles of 1 month was adopted to compare the outcomes of each administered therapeutic in the treatment of refractory stable angina. Drug acquisition and monitoring of patients were considered as the costs data. The clinical data was obtained from the published literature.

Drug acquisition costs were considered in the Budget Impact Analysis. The cost saving potential of the new treatment was estimated for the next 5 years.

RESULTS

Cost-Effectiveness Ratios (ICER) were dominant in the base case scenario. Adding Ranolazine to the SOC provided an additional 0.7 QALYs and decreased total costs by about 6199 USD per patient. The robustness of the model was confirmed by sensitivity analysis. The cost saved over the next 5 years was accounted about 8.4 million dollars following the use of Ranolazine.

CONCLUSIONS

In the treatment of refractory stable angina, adding Ranolazine to the standard of care is more cost-effective than Nicorandil.