OBJECTIVES: High resting heart rate (HR) has been progressively accepted as a modifiable cardiovascular risk factor. Ivabradine is a specific HR lowering agent indicated in chronic stable angina (SA) patients with normal sinus rhythm, contraindicated or intolerant to beta-blockers. This study aimed to estimate the cost-effectiveness of ivabradine versus generic amlodipine in such patients, from the Finnish societal perspective. METHODS: A Markov chain Monte Carlo stochastic simulation model was used to estimate the influence of HR lowering in cardiovascular morbidity and mortality and its economic consequences. Ivabradine, 7.5 mg twice a day, was compared against amlodipine, 10 mg once a day. HR distribution was modelled as a gamma function and survival and time to hospitalization were modelled with weibull functions. Only patients with resting HR>70 bpm were included. Events considered were acute myocardial infarction, stroke, heart failure and death, as well as revascularization procedures (coronary artery bypass graft and percutaneous coronary interventions). Finnish setting was considered, including only direct costs, derived from the 2006 Finnish Guidelines for Healthcare Unit Costs. Effectiveness was measured in life years (LY) and quality-adjusted life years (QALY). Time horizon was set at 20 years and discount rate was 5%/year for costs and effectiveness. RESULTS: For each 100 patients using ivabradine in comparison with amlodipine we estimate a 36 LYs (95%CI: [18;57]) or 30 QALYs (95%CI: [17;47]) gain. Annual incremental cost per patient was €226 (95%CI: [201;243]). Incremental cost-effectiveness ratios for ivabradine utilization were €12,886/LY and €15,060/QALY. For high levels of certainty (>90%), willingness to pay for ivabradine’s benefits didn’t exceed €24,000, regardless of the effectiveness measure considered. CONCLUSIONS: Ivabradine is a cost-effective alternative for the treatment of SA when compared to generic amlodipine in a Finnish setting of patients with contraindication or intolerance to beta-blockers and resting HR>70 bpm.