OBJECTIVES: To determine whether there are certain treatment patterns and cost differences in CHD-patients treated with different nitrates. METHODS: Full data sets of 4 Million patients from SHI of the years 2001 to 2011 were enrolled to identify CHD-patients treated with different nitrates. Demographic data as well as resource consumption were collected. Events related to CHD were identified. Based on this data a Markov model was created to calculate length of stay on a treatment principle, to calculate costs per treatment principle and to calculate the death rate due to different nitrate treatments. For cost analysis, German SHI perspective was chosen. Drug costs were taken from official price lists of 2012. Future costs were discounted by 2.5%. Sensitivity analyses were conducted. RESULTS: More than 1 Million patient biographies were eligible, 14% were CHD-patients and 18,691 (1,85%) patients treated with nitrates were observed. 30 % were male, 20 % on Isosorbidmononitrate (ISMN), 50% on Isosorbiddinitrate (ISDN) and 30 % on PETN. Average starting age was 59.8 years on ISMN, 60 on ISDN and 57.8 on PETN. Demographics were comparable, with more patients living in Eastern Germany. Treatment duration was 16.9 years on ISMN, 16.6 on ISDN and 17.0 on PETN. Mortality rates were 2.5% under ISMN resp. ISDN and 1% under PETN. Total annual costs per patient (excluding hospital costs) were €1,485,- for ISMN, €1,529,- for ISDN and €1,158,- for PETN. PETN-patients receive less additional drugs for CHD, diuretics, psychopharmacotherapeutics and further non-specified drugs. Further analyses indicated that PETN patients are treated more often out-patiently. Sensitivity analyses stated stability of the presented results. CONCLUSIONS: Treatment of CHD-patients with PETN is less costly for SHI. Abdication of PETN due to current fictive approval and higher drug costs – as published recently – will lead to prescription of other nitrates and as consequence, higher costs will accrue.