OBJECTIVES: Ivabradine is approved by the European Medicine Agency for the treatment of Chronic Heart Failure (CHF) NYHA II to IV class with systolic dysfunction in patients in sinus rhythm and whose heart rate is ≥ 75 bpm, in combination with standard therapy including beta-blocker therapy or when beta-blocker therapy is contraindicated or not tolerated. The study objective was to perform a cost-effectiveness analysis of ivabradine based on the outcomes of the SHIFT clinical trial from the perspective of the Irish Health Service Executive (HSE).  METHODS: A six health state Markov model with health states for CHF NYHA classes I to IV, alive, and dead was adapted to the Irish healthcare setting. The economic evaluation compared the cost-effectiveness of ivabradine in combination with standard therapy versus standard therapy alone. A lifetime horizon was chosen in the base case analysis. Costs and effects were discounted at 4% per year. Deterministic and probabilistic sensitivity analyses were performed.  Health state utilities were estimated from EQ-5D index scores obtained from the SHIFT clinical trial. The base case analysis was based on heart failure outcomes and associated costs. RESULTS: When used in addition to standard therapy, ivabradine increased discounted healthcare costs by €2,169 for a 0.23 QALY gain, resulting in an incremental cost per QALY gained of €9,426. In no case of the deterministic sensitivity analysis did the cost per QALY gained increase above €20,000. The probability of the cost-effectiveness of ivabradine at a willingness to pay threshold of €45,000 per QALY gained was estimated to be approx. 100%. CONCLUSIONS: When used in addition to standard therapy, based on heart failure outcomes and associated costs, ivabradine had an incremental cost per QALY gained of €9,426 with an approx. 100% probability of being cost-effective at a willingness to pay threshold of €45,000 per QALY gained.