Abstract
Introduction
Ranolazine is a novel antianginal agent indicated in EU as addon therapy for the symptomatic treatment of patients with stable angina pectoris who are inadequately controlled or intolerant to first-line antianginal therapies. No economic evaluation of the drug has yet been published. This study proposes a pharmacoeconomic analysis in the perspective of the National Health Service, in Italy.
Methods
A short term (one year) decision tree model compares ranolazine added to usual treatment versus usual treatment only. According to treatments, patients are distributed with different probabilities in four bands of angina frequency (minimum, mild, moderate, severe) and face different risks of hospitalisation. The endpoint of the study is the cost per QALY (Quality Adjusted Life Year) gained (ICER, Incremental Cost Effectiveness Ratio). The study is localised to Italy as regards costs: treatment, hospitalisation, surgical intervention resources are evaluated using national prices and tariffs.
Results
The base case resulted in an ICER amounting to €8,500. In the sensitivity analysis, the major critical parameters in the model were the price of ranolazine and the risk of hospitalisation in patients with moderate and mild angina. Assuming unfavourable conditions in a set of parameters simultaneously, the ICER increased to €17,900.
Conclusions
Ranolazine can be considered a cost-effective option for the treatment of chronic angina in Italy. Such result appears robust when tested against uncertainty.
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I peer reviewers, per questo articolo, sono stati coordinati da Mario Eandi.
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Lucioni, C., Mazzi, S. Una valutazione economica di ranolazina add-on nel trattamento dell’angina stabile cronica. Pharmacoeconomics-Ital-Res-Articles 11, 141–152 (2009). https://doi.org/10.1007/BF03320519
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DOI: https://doi.org/10.1007/BF03320519