OBJECTIVES: To compare the costs resulting from a treatment with ivabradine, a new medication for stable angina pectoris patients, with standard care for those patients who cannot be appropriately treated with standard medication in The Netherlands in 2006. METHODS: A decision analytic model was used to estimate the cost-effectiveness of ivabradine in patients with stable angina pectoris, who cannot be appropriately treated with standard medication and are therefore currently candidates for revacularisation (ESC guidelines 2006 on the management of stable angina pectoris). Therefore ivabradine is compared with standard care consisting of revascularization (CABG or PTCA). The study was performed within the society perspective, which included costs of medication and revascularisation procedures. The data sources included published literature, the ivabradine clinical trials, the Euro Heart Survey for stable angina, which provided data from daily practice, and official price/tariff lists and national population statistics. RESULTS: Treatment with ivabradine results in 77% reduction in revascularisation and leads to a cost saving of € 7028 per patient compared with revacularisation during the first year of treatment. Sensitivity analyses showed that extrapolation beyond one year leads to further cost savings. Another sensitivity analysis on the probability of revascularisation showed that cost savings vary from € 2882 to € 9102. CONCLUSION: This model showed that the use of ivabradine compares favourably with revascularisation in treatment of stable angina pectoris in The Netherlands from a budgetary and health economic perspective: the total costs are substantially lower, whereas the effectiveness is at least similar. Consequently ivabradine can be considered a cost-effective treatment being dominant over standard care.