Cost-utility of ranolazine for the symptomatic treatment of patients with chronic angina pectoris in Spain

Hidalgo, Álvaro; Ramos-Goñi, Juan Manuel; Villoro, Renata

doi:10.1007/s10198-013-0534-8

Cited by 12 publications

(10 citation statements)

References 26 publications

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“…A small number of prior European economic analyses performed from the Spanish, 20 Italian 21 and Russian perspectives 22 have also demonstrated the addition of ranolazine to SoC for the treatment of patients with chronic angina can be economically substantiated. Two of these analyses 20 21 reported ICERs for ranolazine of ∼€8500/QALY gained; well below the €30 000/QALY gained willingness-to-pay threshold commonly referenced. The third, a Russian model, 22 did not calculated cost/QALY gained but rather used change in angina frequency as its principal measure of effectiveness.…”

Section: Discussionmentioning

confidence: 99%

“…To our knowledge, this is the first report of the cost-effectiveness of ranolazine from the UK health system perspective, and our findings are supportive of NICE's current recommendation for ranolazine use in stable angina. 8 Additionally, the aforementioned models 20–22 used only direct medical costs, while our model (as a sensitivity analysis) included both direct and indirect costs. The addition of indirect costs to our model yielded an even larger gap (decrease) in treatment costs with the use of ranolazine compared with SOC alone (δ: £488 vs £110), substantiating the benefit of ranolazine from a societal perspective.…”

Section: Discussionmentioning

confidence: 99%

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Ranolazine for the treatment of chronic stable angina: a cost-effectiveness analysis from the UK perspective

2015

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ObjectivesTo estimate the cost-effectiveness of ranolazine when added to standard-of-care (SoC) antianginals compared with SoC alone in patients with stable coronary disease experiencing ≥3 attacks/week.SettingAn economic model utilising a UK health system perspective, a 1-month cycle-length and a 1-year time horizon.ParticipantsPatients with stable coronary disease experiencing ≥3 attacks/week starting in 1 of 4 angina frequency health states based on Seattle Angina Questionnaire Angina Frequency (SAQAF) scores (100=no; 61–99=monthly; 31–60=weekly; 0–30=daily angina).InterventionRanolazine added to SoC or SoC alone. Patients were allowed to transition between SAQAF states (first cycle only) or death (any cycle) based on probabilities derived from the randomised, controlled Efficacy of Ranolazine in Chronic Angina trial and other studies. Patients not responding to ranolazine in month 1 (not improving ≥1 SAQAF health state) discontinued ranolazine and were assumed to behave like SoC patients.Primary and secondary outcomes measuresCosts (£2014) and quality-adjusted life-years (QALYs) for patients receiving and not receiving ranolazine.ResultsRanolazine patients lived a mean of 0.701 QALYs at a cost of £5208. Those not receiving ranolazine lived 0.662 QALYs at a cost of £5318. The addition of ranolazine to SoC was therefore a dominant economic strategy. The incremental cost-effectiveness ratio was sensitive to ranolazine cost; exceeding £20 000/QALY when ranolazine's cost was >£203/month. Ranolazine remained a dominant strategy when indirect costs were included and mortality rates were assumed to increase with worsening severity of SAQAF health states. Monte Carlo simulation found ranolazine to be a dominant strategy in ∼71% of 10 000 iterations.ConclusionsAlthough UK-specific data on ranolazine's efficacy and safety are lacking, our analysis suggest ranolazine added to SoC in patients with weekly or daily angina is likely cost-effective from a UK health system perspective.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Ranolazine for the treatment of chronic stable angina: a cost-effectiveness analysis from the UK perspective

2015

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“…A decision tree model [ 24 ] was locally adapted to evaluate the cost-utility of ranolazine as add-on therapy to SoC, compared to SoC alone, during a 6-month period (time horizon) in patients with stable angina, who did not respond adequately to first line therapy with b-blockers and/or calcium channel antagonists in Greece. The analysis was conducted from a third-party payer perspective (National Organization for Healthcare Services Provision [EOPYY]).…”

Section: Methodsmentioning

confidence: 99%

Ranolazine for the symptomatic treatment of patients with chronic angina pectoris in Greece: a cost-utility study

Kourlaba

Vlachopoulos²,

Parissis

et al. 2015

BMC Health Serv Res

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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.

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“…Recent pharmaco-economic studies conducted both in Europe and in the USA have shown ranolazine to be cost-effective in patients with chronic stable angina. A recent study from Spain calculated the incremental cost-utility ratio of using ranolazine compared with a placebo and showed that the incremental cost-utility ratio is 8,455 Euro per quality-adjusted life-year (QALY)/patient in Spain and that the incremental cost-utility ratio is particularly effective in non-hospitalized patients with mild or moderate angina frequency [ 26 ].…”

Section: Clinical Indication For the Use Of Ranolazine In Chronic Stamentioning

confidence: 99%

Ranolazine

Rosano¹,

Vitale²,

Volterrani³

2015

Pharmacological Treatment of Chronic Stable Angina Pectoris

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Cost-utility of ranolazine for the symptomatic treatment of patients with chronic angina pectoris in Spain

Abstract: Ranolazine is a highly efficient add-on therapy for the symptomatic treatment of chronic angina pectoris in patients who are inadequately controlled by, or intolerant to, first-line antianginal therapies in Spain.

Cited by 12 publications

References 26 publications

Ranolazine for the treatment of chronic stable angina: a cost-effectiveness analysis from the UK perspective

Ranolazine for the treatment of chronic stable angina: a cost-effectiveness analysis from the UK perspective

Ranolazine for the symptomatic treatment of patients with chronic angina pectoris in Greece: a cost-utility study

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