Format

Send to

Choose Destination
Int J Cardiol. 2018 Dec 15;273:34-38. doi: 10.1016/j.ijcard.2018.09.060. Epub 2018 Sep 21.

Ranolazine in patients with type 2 diabetes and chronic angina: A cost-effectiveness analysis and assessment of health-related quality-of-life.

Author information

1
Idaho State University, College of Pharmacy, Meridian, ID, United States of America.
2
University of Connecticut, Schools of Pharmacy and Medicine, Storrs and Farmington, CT, United States of America.
3
Medical University of South Carolina, College of Pharmacy, Charleston, SC, United States of America. Electronic address: weeda@musc.edu.

Abstract

BACKGROUND:

Type 2 diabetes (T2D) is associated with a high burden of angina. Ranolazine has been shown to reduce angina frequency versus placebo in patients with T2D and stable angina. We sought to estimate the cost-effectiveness of ranolazine when added to standard-of-care (SoC) versus SoC alone in patients with T2D and stable, but symptomatic coronary disease despite treatment with 1-2 antianginals.

METHODS:

A Markov model was developed and evaluated using cohort simulation. The model utilized a US societal perspective, 1-month cycle length and 1-year time horizon and was developed to estimate the cost-effectiveness of ranolazine versus SoC. Patients entered the model in 1 of 4 angina frequency health states based on baseline Seattle Angina Questionnaire Angina Frequency scores (100 = no; 61-99 = monthly; 31-60 = weekly; 0-30 = daily) and could transition between health states (first cycle only) or to death (any cycle) based on probabilities derived from the Type 2 Diabetes Evaluation of Ranolazine in Subjects with Chronic Stable Angina trial.

RESULTS:

Our model estimated patients treated with ranolazine lived a mean of 0.728 quality adjusted life years (QALYs) at a cost of $16,654. Those not receiving ranolazine lived a mean of 0.702 QALYs and incurred costs of $15,476. The incremental cost-effectiveness ratio for the addition of ranolazine to SoC was $45,308/QALY. Short Form-36 data suggest improvements in patients' bodily pain drove the gain in QALYs associated with ranolazine (2.73 versus 3.96, p = 0.01).

CONCLUSION:

Our model suggests the addition of ranolazine to SoC is likely cost-effective from a US societal perspective for the treatment of patients with T2D and stable, symptomatic coronary disease despite treatment with 1-2 antianginals.

KEYWORDS:

Cost-effectiveness analysis; Diabetes mellitus; Ranolazine; Stable angina; Type 2

PMID:
30266352
DOI:
10.1016/j.ijcard.2018.09.060
[Indexed for MEDLINE]

Supplemental Content

Full text links

Icon for Elsevier Science
Loading ...
Support Center