BACKGROUND: Heart failure (HF) represents a significant economic burden worldwide with hospitalizations as main cost driver. Ivabradine, has been granted in the treatment of symptomatic heart failure patients, based on SHIFT trial.OBJECTIVES: To evaluate the cost-effectiveness of Ivabradine on top of standard care of heart failure versus standard care alone in Thai patients from the national healthcare perspective.METHODS: An economic evaluation based on clinical benefits observed and resources consumed during the SHIFT, a randomized placebo-controlled trial, with ivabradine on top of standard care compared to standard care alone with a mean follow up of 22.9 months. The principal results  were -18% and -26% relative risk reduction from cardiovascular death or hospitalization for heart failure and hospitalization for worsening heart failure. Risk equations were built based on SHIFT data, adjusting clinical benefits to Thai patient profile obtained from literature review. Drug local costs were the lowest median prices from ministry of public health database. Hospital costs were extracted from a public hospital database on HF admission during January-December 2011 representing 1,276 patient-treatment days, with mean hospital charges combined in Thai baht(THB). The incremental cost-effectiveness ratios (ICER) were calculated and expressed in cost/life years gained (LYG) and cost/ Quality-Adjusted Life Years gained (QALYg). Probabilistic sensitivity analysis was performed.RESULTS: Mean total cost [95% CI], LY and QALY gained were 224,880[220,470 - 228,978]THB, 2.12 LY and 1.52 QALY respectively, for Thai heart failure patients treated by ivabradine on top of standard care, while 227,884[222,736-232,667]THB, 2.09 LY and 1.49 QALY respectively for patients treated by standard care alone. As results, ivabradine on top of standard care provided an ICER of 134,281THB/LYG and 109,415THB/QALYg compared with standard care alone.CONCLUSIONS: Ivabradine on top of standard care treatment for Thai heart failure patient is dominant as compared with standard care alone resulting in LYG, QALY gains of 134,281THB and 109,415 THB.