Economic evaluation of trimetazidine in the management of chronic stable angina in Greece.
BACKGROUND
To evaluate the cost-effectiveness of trimetazidine (TMZ) as add-on therapy to standard-of-care (SoC) compared to SoC alone in patients with chronic stable angina who did not respond adequately to first line therapy with b-blockers, nitrates or calcium channel antagonists in Greece.


METHODS
A Markov model with 3-month cycles and 1-year time horizon was developed to assess the comparators. The analysis was conducted from a third-party payer perspective. The clinical inputs and utility values were extracted from the published literature. Resource consumption data were obtained from local experts, using a questionnaire developed for the purpose of the study and were combined with unit cost data (in €2016) obtained from official sources. Cost effectiveness was assessed by calculating the incremental cost effectiveness ratio (ICER). Probabilistic sensitivity analysis (PSA) was performed to account for uncertainty and variation in the input parameters of the model.


RESULTS
The analysis showed that the cost of TMZ plus SoC was €1755.57 versus €1751.76 of SoC alone. In terms of health outcomes, TMZ plus SoC was associated with 0.6650 QALYs versus 0.6562 QALYs for SoC alone. The incremental analysis resulted in an ICER of €430.67 per QALY gained. PSA revealed that the probability of TMZ plus SoC being cost-effective over SoC was 89 %, at a threshold of €34,000 per QALY gained.


CONCLUSIONS
The results indicate that TMZ as add -on treatment may be a highly cost-effective option for the symptomatic treatment of patients with chronic stable angina in Greece relative to SoC alone.
The Stavros Niarchos Foundation-Collaborative Center for Clinical Epidemiology and Outcomes Research (CLEO), National and Kapodistrian University of Athens, School of Medicine, Thivon & Papadiamantopoulou, Athens, 115 27, Greece. kurlaba@gmail.com.
Georgia
G
Kourlaba
Department of Health Services Organization & Management, National School of Public Health, Athens, Greece.
George
G
Gourzoulidis
Cardiology Department, Henry Dunant Hospital Center, Athens, Greece.
George
G
Andrikopoulos
Hippokration General Hospital, First Cardiology Clinic, University of Athens, Athens, Greece.
Konstantinos
K
Tsioufis
Servier Hellas, Athens, Greece.
Alexandra
A
Beletsi
Department of Health Services Organization & Management, National School of Public Health, Athens, Greece.
Nikos
N
Maniadakis
Angina pectoris; Coronary disease; Cost-utility; Vastarel
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