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We aimed to investigate the pharmacoeconomic efficacy of ivabradine and nebivolol in treatment of stable angina pectoris patients with left ventricular dysfunction.
This prospective study included 34 patients with a left ventricular ejection fraction (LVEF) ≤40% that were followed-up by the cardiology department; 15 (44%) patients were male, 19 (56%) were female, and mean age was 61±5.1 years. Patients treated with nebivolol (17 patients, 50%) formed nebivolol group, patients who could not tolerate nebivolol and treated with ivabradine (17 patients, 50%) formed ivabradine group. The parameters recorded included heart rates, LVEF, hospitalization rates, quality of life (QoL) based on the Seattle Angina Questionnaire (SAQ) scores, the Duke Treadmill Score (DTS). Pharmacoeconomic analysis was performed by using Cost Minimization Analysis (CMA), and Cost Effectiveness Analysis (CEA).
After 6 months’ treatment ivabradine (mean dose 12±2.5 mg daily) reduced heart rate by (102±8.9) to (66±3.2) beat per minute (bpm), (p<0.05), and nebivolol (mean dose 4±0.8 mg/day) reduced heart rate by (105±9.1) to (67±4.3) bpm (p<0.05). LVEF for the nebivolol group improved by (38±6.5) to (41±3.2), (p>0.05) and for the ivabradine group (37±5.4) to (41±2.3), (p>0.05). The mean MET value in the nebivolol group increased from (3.7±1.2) to (5.5±1.6), (p>0.05), versus from (3.6±1.5) to (5.5±1.4), (p>0.05) in the ivabradine group. After 6 months’ treatment CMA results showed a difference in the total cost of treatment was $ 5288.70 in favor of nebivolol.
The findings of this study suggest that nebivolol is more cost-effective than ivabradine in the treatment of stable angina pectoris in patients with left ventricular dysfunction.