Walker, A., McMurray, J. , Stewart, S., Berger, W., McMahon, A., Dargie, H., Fox, K., Hillis, S., Henderson, N. and Ford, I. (2006) Economic evaluation of the impact of nicorandil in angina (IONA) trial. Heart, 92, pp. 619-624. (doi: 10.1136/hrt.2003.026385) (PMID:16614274) (PMCID:PMC1860935)
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Abstract
Objective: To estimate the net cost of adding nicorandil to usual treatment for patients with angina and to compare this with indicators of health benefit. Design: Cost effectiveness analysis Setting: Based on results of the IONA (impact of nicorandil on angina) trial. Patients: Patients with angina fulfilling the entry criteria for the IONA trial Interventions: In one arm of the trial nicorandil was added to existing antianginal treatment and compared with existing treatment alone. Main outcome measures: 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. Results: The net cost for each additional IONA trial end point averted was -£5 (-€7). The net cost for each case of acute coronary syndrome averted was -£8 (-€12). The net cost for each event-free survivor was -£5 (-€7). These figures are based on gastrointestinal events that were judged definitely or probably related to nicorandil. When all gastrointestinal events were included these three ratios rose to £567 (€835), £886 (€1305), and £516 (€760), respectively. Conclusions: A substantial amount of the additional cost of nicorandil is offset by reduced use of hospital services. The limited comparisons possible with other CHD interventions suggest that nicorandil compares favourably.
| Item Type: | Articles |
|---|---|
| Status: | Published |
| Refereed: | Yes |
| Glasgow Author(s) Enlighten ID: | Walker, Dr Andrew and Ford, Professor Ian and McMahon, Dr Alex and McMurray, Professor John |
| Authors: | Walker, A., McMurray, J., Stewart, S., Berger, W., McMahon, A., Dargie, H., Fox, K., Hillis, S., Henderson, N., and Ford, I. |
| College/School: | College of Medical Veterinary and Life Sciences > School of Cardiovascular & Metabolic Health College of Medical Veterinary and Life Sciences > School of Health & Wellbeing > Robertson Centre College of Medical Veterinary and Life Sciences > School of Medicine, Dentistry & Nursing > Dental School |
| Journal Name: | Heart |
| Publisher: | BMJ Publishing Group |
| ISSN: | 1355-6037 |
| ISSN (Online): | 1468-201X |
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