title: Costs and clinical outcomes associated with use of ranolazine for treatment of angina.
abstract: BACKGROUND
  There are 10 million patients with angina in the United States (500,000 new diagnoses annually). Although clinical efficacy of angina treatments is understood, total costs of care and clinical outcomes for patients with chronic angina in different treatment protocols are unknown.
  
  
  OBJECTIVE
  Our objective was to estimate total costs of care and revascularization rates for patients with poorly controlled angina who added either (1) long-acting nitrates, (2) beta blockers or calcium channel blockers, or (3) ranolazine to their therapy.
  
  
  METHODS
  We performed retrospective claims analysis using an index event involving change of therapy in which a new antiangina drug was added.
  
  
  METHODS
  Using a large commercial insurance claims database, 4545 patients with angina with an index event (ie, change of antiangina therapy) and 6 months of continuous enrollment pre- and postindex event were identified. Using total cost of care and revascularization rates, we first compared preindex disease burden, medical care use, and total cost of care and components of total cost. We then compared unadjusted use and cost of care across treatment groups. Finally, we estimated regression models to predict postindex event total costs of care and revascularization rates.
  
  
  RESULTS
  During the preindex period, the 3 comparison groups had similar health measures, medical care use, and total costs of care. During the postindex period, ranolazine users had lower revascularization rates (9.9%) than comparison patient groups (15.4%-20.4%, both Ps < 0.001). Ranolazine users had lower total costs of care ($13,961) than the nitrate group ($18,166, 30.0% higher; P < 0.001) and the beta blockers/calcium channel blockers group ($17,612, 26.6% higher; P = 0.002).
  
  
  CONCLUSIONS
  Adding ranolazine to the treatment regimen of patients with poorly controlled angina was associated with lower rates of revascularization and lower total costs of care than for comparable patients, differences both statistically and clinically relevant.
authors.affiliation: University of Rochester, Rochester, New York, USA. charles.phelps@rochester.edu
authors.forename: Charles E
authors.initials: CE
authors.lastname: Phelps
authors.forename: Erin K
authors.initials: EK
authors.lastname: Buysman
authors.forename: Gabriel
authors.initials: G
authors.lastname: Gomez Rey
mesh_terms: D000083:Acetanilides / Q000627:therapeutic use*; D000787:Angina Pectoris / Q000188:drug therapy*; D003362:Cost-Benefit Analysis; D016527:Drug Costs; D005260:Female; D006801:Humans; D007345:Insurance Claim Review; D008297:Male; D008875:Middle Aged; D010879:Piperazines / Q000627:therapeutic use*; D000069458:Ranolazine; D016896:Treatment Outcome
chemical_list: D000083:Acetanilides; D010879:Piperazines; D000069458:Ranolazine