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

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Abstract

Background

Ranolazine is an antianginal agent that was approved in the EU in 2008 as an add-on therapy for symptomatic chronic angina pectoris treatment in patients who are inadequately controlled by, or are intolerant to, first-line antianginal therapies. These patients’ quality of life is significantly affected by more frequent angina events, which increase the risk of revascularization.

Objective

To assess the cost-utility of ranolazine versus placebo as an add-on therapy for the symptomatic treatment of patients with chronic angina pectoris in Spain.

Methods

A decision tree model with 1-year time horizon was designed. Transition probabilities and utility values for different angina frequencies were obtained from the literature. Costs were obtained from Spanish official DRGs for patients with chronic angina pectoris. We calculated the incremental cost-utility ratio of using ranolazine compared with a placebo. Sensitivity analyses, by means of Monte Carlo simulations, were performed. Acceptability curves and expected value of perfect information were calculated.

Results

The incremental cost-utility ratio was €8,455 per quality-adjusted life-year (QALY) per patient in Spain. Sensitivity analyses showed that if the decision makers’ willingness to pay is €15,000 per QALY, the treatment with ranolazine will be cost effective at a 95 % level of confidence. The incremental cost-utility ratio is particularly sensitive to changes in utility values of those non-hospitalized patients with mild or moderate angina frequency.

Conclusions

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.

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Acknowledgments

The authors thank Antonio Zapata, Elena Saura, and Mónica Casañas from Grupo Menarini Spain, for the help provided for the study. The study was financed by Grupo Menarini, Spain.

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Authors and Affiliations

  1. Facultad de Ciencias Jurídicas y Sociales de Toledo, Análisis Económico y Finanzas, Castilla-La Mancha University, Cobertizo de San Pedro Mártir s/n, 45071, Toledo, Spain

    Álvaro Hidalgo-Vega

  2. HTA Unit of Canary Islands Health Service, C/Calvario no 271-B 1° IZQ, 38350, Tacoronte, Canary Islands, Spain

    Juan Manuel Ramos-Goñi

  3. Red de Investigación de Servicios Sanitarios En Cronicidad (REDISSEC), Tacoronte, Spain

    Juan Manuel Ramos-Goñi

  4. Weber, Economía y Salud, C/Norias 123. Majadahonda, 28221, Madrid, Spain

    Renata Villoro

Authors
  1. Álvaro Hidalgo-Vega
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  2. Juan Manuel Ramos-Goñi
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  3. Renata Villoro
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Correspondence to Juan Manuel Ramos-Goñi.

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Hidalgo-Vega, Á., Ramos-Goñi, J.M. & Villoro, R. Cost-utility of ranolazine for the symptomatic treatment of patients with chronic angina pectoris in Spain. Eur J Health Econ 15, 917–925 (2014). https://doi.org/10.1007/s10198-013-0534-8

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  • DOI: https://doi.org/10.1007/s10198-013-0534-8

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