title: Ranolazine for the symptomatic treatment of patients with chronic angina pectoris in Greece: a cost-utility study.
abstract: BACKGROUND
  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.
  
  
  METHODS
  A 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.
  
  
  RESULTS
  Ranolazine 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 %.
  
  
  CONCLUSIONS
  Τhe 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.
authors.affiliation: The Stavros Niarchos Foundation-Collaborative Center for Clinical Epidemiology and Outcomes Research (CLEO), National and Kapodistrian University of Athens, School of Medicine, Athens, Greece. kurlaba@gmail.com.
authors.forename: Georgia
authors.initials: G
authors.lastname: Kourlaba
authors.affiliation: 1st Department of Cardiology, Athens University Hospital "Ippokrateio", Athens, Greece. cvlachop@otenet.gr.
authors.forename: Charalambos
authors.initials: C
authors.lastname: Vlachopoulos
authors.affiliation: Heart Failure Unit, Department of Cardiology, Athens University Hospital "Attikon", Athens, Greece. jparissis@yahoo.com.
authors.forename: John
authors.initials: J
authors.lastname: Parissis
authors.affiliation: Department of Cardiology, "Alexandra" Hospital, Athens, Greece. jkanakakis@yahoo.gr.
authors.forename: John
authors.initials: J
authors.lastname: Kanakakis
authors.affiliation: Department of Health Services Organization & Management, National School of Public Health, Athens, Greece. gourzoulidis.g@gmail.com.
authors.forename: George
authors.initials: G
authors.lastname: Gourzoulidis
authors.affiliation: Department of Health Services Organization & Management, National School of Public Health, Athens, Greece. nmaniadakis@esdy.edu.gr.
authors.forename: Nikos
authors.initials: N
authors.lastname: Maniadakis
mesh_terms: D000787:Angina Pectoris / Q000188:drug therapy* / Q000191:economics; D002317:Cardiovascular Agents / Q000191:economics / Q000627:therapeutic use*; D002908:Chronic Disease / Q000188:drug therapy* / Q000191:economics; D003362:Cost-Benefit Analysis; D003663:Decision Trees; D004305:Dose-Response Relationship, Drug; D006115:Greece / Q000453:epidemiology; D006801:Humans; D008875:Middle Aged; D011788:Quality of Life; D019057:Quality-Adjusted Life Years; D000069458:Ranolazine / Q000191:economics / Q000627:therapeutic use*; D059039:Standard of Care / Q000191:economics*
chemical_list: D002317:Cardiovascular Agents; D000069458:Ranolazine