OBJECTIVES To assess cost-effectiveness of ranolazine in Russian patients with angina pectoris. METHODS A model was developed to compare a strategy of treatment of angina pectoris with ranolazine and a traditional therapy in patients with at least 3 heart attacks per week. The analysis was based on the results of ERICA (Efficacy of Ranolazine in Chronic Angina) study that included Russian patients and reflected a routine Russian practice for the treatment of the disease. The analysis included costs of drug therapy, emergency care and hospitalization. Effectiveness rate was measured as a change of frequency of angina attacks compared to initial level estimated by SAQ (Seattle Angina Questionnaire). Sensitivity analysis considered the change of parameters in different length of hospitalization. RESULTS Total costs in ranolazine group were insignificanlty higher than in control group (573.84 RUB per patient). At the same time, ranolazine changed the structure of costs: expenditures on medications grew while costs of emergency care and hospitalization reduced. CER value was 1640.86 in ranolazine group, and 1964.63 (1.2 times less) in group of traditional therapy. The change of hospitalization length in sensitivity analysis was also more favorable in case of ranolazine: 164 479.81 vs 197 300.02 RUB/unit, which confirms previous results. CONCLUSIONS The use of ranolazine in patients with >3 heart attacks of angina pectoris per week is clinically and economically substantiated.