Abstract
To estimate the net cost of adding nicorandil to usual treatment for patients with angina and to compare this with indicators of health benefit. Cost effectiveness analysis. Based on results of the IONA (impact of nicorandil on angina) trial. Patients with angina fulfilling the entry criteria for the IONA trial. In one arm of the trial nicorandil was added to existing antianginal treatment and compared with existing treatment alone. Costs were for use of hospital resources (for cardiovascular, cerebrovascular, and gastrointestinal reasons), nicorandil, and care after hospital discharge. Benefits were assessed in three ways: (1) IONA trial primary outcome (coronary heart disease (CHD) death, non-fatal myocardial infarction, or hospital admission for cardiac chest pain); (2) acute coronary syndrome (CHD death, non-fatal myocardial infarction, or unstable angina); and (3) event-free survivors at the end of the trial. The net cost for each additional IONA trial end point averted was -5 pounds sterling (-7 euros). The net cost for each case of acute coronary syndrome averted was -8 pounds sterling (-12 euros). The net cost for each event-free survivor was -5 pounds sterling (-7 euros). These figures are based on gastrointestinal eve...Continue Reading
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