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stable angina is a socially significant disease that requires significant financial costs to the health system and patients. In recent years the increased heart rate has been considered as a significant risk factor for poor prognosis in stable angina. The aim of the research: assessment of the economic viability of the inclusion of ivabradine in the scheme of treatment of stable angina in terms of health care system of the Republic of Belarus. Material and methods. Markov’s model of ivabradine use in patients with stable angina pectoris has been constructed on the basis of a systematic review of the literature, national surveillance data, local health services market and cardiovascular drugs market estimation. “Cost-effectiveness” and “cost-utility” analyses have been used. The target population of patients suffering from angina pectoris and in need of ivabradine prescription has been estimated with data from clinical studies and national epidemiological data. The potential effectiveness of ivabradine in the Belarusian patient population has been evaluated. Results. The size of the target patient population with stable angina for the ivabradine prescription was 17559 people. The use of ivabradine within 18 months in the target population patient with increased heart rate would allow potentially prevent 366 cases of nonfatal myocardial infarction and unstable angina, 143 cases of cardiovascular death, 391 case of revascularization. According to the results of the analysis the prescription of ivabradine in optimum dose with a minimum cost per 1 mg is the optimum pharmacoeconomic acceptability in patients with stable angina and high heart rate (70 beats per minute).

About the Authors

I. N. Kozhanova
Belarusian State Medical University (Belarus, Minsk)
Russian Federation

I. S. Romanova
Belarusian State Medical University (Belarus, Minsk)
Russian Federation

L. N. Gavrilenko
Belarusian State Medical University (Belarus, Minsk)
Russian Federation

A. V. Patseev
Republican Scientific Practical Center «Cardiology» (Belarus, Minsk)
Russian Federation

M. M. Sachek
Republican Scientific Practical Center of Medical Technologies, Computer Systems, Administration and Management of Health (Belarus, Minsk)
Russian Federation


1. State statistical reports. Approved by the Resolution of the National Statistics Committee of Belarus 11.08.2010 № 165. 2011. (In Russ.).

2. Zyryanov S.K., Belousov Yu.B. ABC / VEN-analysis [Teaching aid. ABC/VEN-analiz. Uchebno-metodicheskoe posobie]. Moscow. 2004.

3. Instructions for use «Pharmacoeconomic rationale for the use of drugs with proven efficacy for the treatment of patients with chronic diseases in terms of practical health care.» Approved by the Ministry of Health, registration number 041-0508, 2008 (In Russ.).

4. Clinical and economic analysis (evaluation, selection of medical technology and quality control of medical care). PA Vorobyev, MV Avksentiev AS Yuriev, MV Sura (ed). [Kliniko-ekonomicheskii analiz (otsenka, vybor meditsinskikh tekhnologii i upravlenie kachestvom meditsinskoi pomoshchi) / P.A. Vorob'ev, M.V. Avksent'eva, A.S. Yur'ev, M.V. Sura]. Moscow. 2004; 404 s.

5. Mrochek A.G. i dr. Kardiologiya v Belarusi. 2012; 5: 99-112.

6. CHOosing Interventions that are Cost Effective (WHO-CHOICE). Mode of access:

7. Fox K. et al. Relationship between ivabradine treatment and cardiovascular outcomes in patients with stable coronary artery disease and left ventricular systolic dysfunction with limiting angina: a subgroup analysis of the randomized, controlled BEAUTIFUL trial. Eur. Heart. J. 2009; 30 (19): 2337-45.

8. Holmes D. et al. The effect of medical and surgical treatment on subsequent sudden cardiac death in patients with coronary artery disease: a report from the Coronary Artery Surgery Study. Circulation. 1986; 73: 1254-1263.

9. Jorge F. Cost-effectiveness analysis of Procoralan® (ivabradine) for symptomatic treatment of chronic stable angina pectoris in patients with normal sinus rhythm, who have a contra-indication or intolerance for beta-blockers. ExigoConsultores for Servier.

10. Matthew T. et al. A review of health utilities using the EQ-5D in studies of cardiovascular disease. Health and Quality of Life Outcomes. Mode of access:

11. Mortality Country Sheet 2006: Great Britain, France, Germany, Poland, Belarus, Russian Federation. 2007. Mode of access: http://www. Global InfoBase Online/International Comparisons.

12. Pepine C. et al. A calcium antagonist vs a non–calcium antagonist hypertension treatment strategy for patients with coronary artery disease. The International Verapamil-Trandolapril Study (INVEST): a randomized controlled trial. JAMA. 2003; 290: 2805-2816.

13. Rambihar S. et al. Heart Rate is associated with Increased Risk of Major Cardiovascular Events, Cardiovascular and All-Cause Death in Patients with Stable Chronic Cardiovascular Disease – An Analysis of ONTARGET/ TRANSCEND. Circulation. 2010; 122: A12677.


For citations:

Kozhanova I.N., Romanova I.S., Gavrilenko L.N., Patseev A.V., Sachek M.M. CLINICAL AND ECONOMIC EVALUATION OF IVABRADINE USE IN STABLE ANGINA IN TERMS OF REPUBLIC OF BELARUS HEALTH CARE SYSTEM. FARMAKOEKONOMIKA. Modern Pharmacoeconomics and Pharmacoepidemiology. 2014;7(2):38-43. (In Russ.)

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