Economic evaluation of trimetazidine in the management of chronic stable angina in GreeceReport as inadecuate

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BMC Health Services Research

, 16:520

Utilization, expenditure, economics and financing systems


BackgroundTo 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.

MethodsA 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.

ResultsThe 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.

ConclusionThe 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.

KeywordsCoronary disease Cost-utility Vastarel Angina pectoris AbbreviationsATPAdenosine triphosphate

CABGCoronary artery bypass grafting

CEACCost-effectiveness acceptability curve

DRGsDiagnostic Related Groups

EMAEuropean Medicines Agency

GDPGross Domestic Product

ICERIncremental cost effectiveness ratio

ICUIntensive care unit

IMFInternational Monetary Fund

INNActive substances

KOLsLocal key opinion leaders

OWSAOne-way sensitivity analysis

PCIPercutaneous coronary intervention

PSAProbabilistic sensitivity analysis

QALYsQuality adjusted life years



WHOWorld Health Organization


Electronic supplementary materialThe online version of this article doi:10.1186-s12913-016-1779-6 contains supplementary material, which is available to authorized users.

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Author: Georgia Kourlaba - George Gourzoulidis - George Andrikopoulos - Konstantinos Tsioufis - Alexandra Beletsi - Nikos Maniadakis


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