Abstract
BackgroundTo conduct an economic evaluation comparing ranolazine as add-on therapy to standard-of-care (SoC) with SoC alone in patients with stable angina who did not respond adequately to first line therapy, in Greece.MethodsA decision tree model was locally adapted in the Greek setting to evaluate the cost-utility of ranolazine during a 6-month period. The analysis was conducted from a third-party payer perspective. The clinical inputs were extracted from the published literature. The cost inputs considered in the model reflect drug acquisition, hospitalizations, vascular interventions and monitoring of patients. The resource utilization data were obtained from 3 local experts. All costs refer to the year 2014. Cost-effectiveness was assessed by means of the incremental cost per quality adjusted life year (QALY) gained with the ranolazine as add-on therapy relative to SoC alone (ICER). Probabilistic sensitivity analysis (PSA) was performed.ResultsRanolazine as add-on therapy was more costly compared to SoC alone, as the 6-month total cost per patient was €1170 and € 984, respectively. Patients received ranolazine plus SoC and SoC alone gained 0.3155 QALYs and 0.2752 QALYs, respectively. Ranolazine plus SoC resulted in an ICER equal to €4620 per QALY gained, well below the threshold of €34,000 per QALY gained. The PSA showed that the likelihood of ranolazine plus SoC being cost-effective at the threshold of €34,000 per QALY gained was 100 %.ConclusionsΤhe results suggest that ranolazine as add–on treatment may be a cost-effective alternative for the symptomatic treatment of patients with chronic stable angina in Greece.Electronic supplementary materialThe online version of this article (doi:10.1186/s12913-015-1228-y) contains supplementary material, which is available to authorized users.
Highlights
To conduct an economic evaluation comparing ranolazine as add-on therapy to standard-of-care (SoC) with SoC alone in patients with stable angina who did not respond adequately to first line therapy, in Greece
In terms of health outcomes, the analysis revealed that ranolazine was more effective compared to SoC alone in terms of quality adjusted life year (QALY)
Under the base case assumptions, incremental analysis showed that ranolazine plus SoC resulted in an incremental cost of €4620 per QALY gained, well below the predetermined WTP threshold of €34,000 per QALY gained [Table 3]
Summary
To conduct an economic evaluation comparing ranolazine as add-on therapy to standard-of-care (SoC) with SoC alone in patients with stable angina who did not respond adequately to first line therapy, in Greece. Despite the aggressive use of conventional antianginal therapies, many patients experience persistent angina [11, 12] For this reason, the need for additional antianginal agents with novel mechanisms of action arose. Ranolazine is a drug that reduces angina symptoms, with a mechanism of action different from that of currently available pharmacological therapies [17,18,19,20]. It was approved on July 9, 2008 by the European Medicines Agency for use in patients with chronic angina, who continue to be symptomatic on bblockers, and/or calcium antagonists [21]
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