Abstract 123: Revascularization Rate and Associated Costs Among Patients With Stable Ischemic Heart Disease Initiating Ranolazine versus Traditional Antianginals

Abstract

Background: Real-world data are limited on resource utilization for revascularization procedures and associated healthcare costs for patients treated with ranolazine versus traditional antianginals. Objective: Describe frequency and costs of revascularization procedures among patients with stable ischemic heart disease (SIHD) initiating ranolazine versus traditional antianginals. Methods: Using Marketscan claims databases between 1/1/07-6/30/15, we identified adult patients with one of the following qualifying diagnosis codes: angina (stable or unstable), myocardial infarction, percutaneous coronary intervention (PCI) or coronary artery bypass grafting (CABG) who initiated ranolazine or a traditional antianginal (beta-blocker [BB], calcium channel blocker [CCB], or long-acting nitrate [LAN]) as second or third line therapy. To be included, patients had to be continuously enrolled for ≥12 months prior to and after the date of qualifying antianginal prescription. Inverse probability weighting based on propensity score was employed to balance the ranolazine and traditional antianginals cohorts on patient clinical characteristics. Outcomes of interest were frequency and total cost of revascularization procedures (PCI or CABG) over a 12-month follow-up. Results: Analysis included 19,574 patients initiating ranolazine (mean age 67 years; 59.2% male), 23,206 initiating BB (67 years; 57.7% male), 26,225 initiating CCB (67 years; 59.0% male), and 39,736 patients initiating LAN (67 years; 59.1% male). Overall, patients initiating CCB had the lowest rate of revascularization. Fewer ranolazine patients had revascularization procedures than BB and LAN patients. (Table). Ranolazine patients also had fewer hospitalizations with revascularization procedures and shorter length of stay than BB and LAN patients. Healthcare costs associated with revascularization were lower among ranolazine patients ($2933) than among BB ($4465) and LAN ($3609) patients (p<0.001), but similar to CCB patients ($2753, p=0.29). Conclusions: Frequency of revascularization procedures and associated healthcare costs were lower among patients with SIHD initiating ranolazine compared to patients initiating BB or LAN as antianginal therapy, and comparable to patients initiating CCBs.