OBJECTIVES: In the SHIFT trial, ivabradine administered to chronic heart failure (CHF) patients in combination with standard therapy significantly reduced cardiovascular death and hospital admission for cardiovascular problems. An economic evaluation of ivabradine plus standard care against standard care alone, for the management CHF in patients with a baseline heart rate ≥75b.p.m. was conducted from the Greek third party-payer perspective. METHODS: An existing Markov model consisting of two health states for CHF NYHA classes I to IV (i.e. alive, dead) was adapted to the Greek health care setting. In each one month cycle, patients can either remain alive or die, during their life span or 29 months (i.e. within SHIFT trial period). Health state utilities were estimated from EQ-5D index scores obtained from the SHIFT clinical trial and using appropriate modeling techniques the data were extrapolated beyond the trial period. All costing data reflects the year 2013. Probabilistic sensitivity analyses (PSA) were conducted. Both cost and outcomes were discounted at 3.5% per year. RESULTS: Results for within trial analysis revealed that ivabradine had an incremental cost and incremental QALY of €905 and 0.05 respectively, leading to an incremental cost per QALY gained of €16,635/QALY. Ivabradine was a cost-effective alternative at a willingness to pay threshold of €36,000 per QALY gained  Moreover, the cumulated lifetime analysis showed incremental cost of €2,792 and incremental QALY of 0.28. The ICER for ivabradine was calculated to be €9,986 per QALY gained. The PSA showed that the likelihood of ivabradine plus standard therapy being cost-effective at a threshold of €36,000/QALY was found to be 96% in both within trial and lifetime analysis. This result is driven by a reduction in mortality and hospitalisations and the associated costs of care.  CONCLUSIONS: Ivabradine   added to standard care could be a cost-effective treatment for the treatment in CHF patients in Greece.