COST-EFFECTIVENESS STUDY OF NITRATE THERAPY USING A DECISION-ANALYSISMETHODOLOGY

The cost-assessment technology of decision analysis was applied to iso sorbide dinitrate (ISDN), the standard therapy for angina; isosorbide mononitrate (ISMO), approved mid-1992; and nitroglycerin patches to me asure the effect of economics on clinical practice and administrative choices. The evaluation was conducted to illustrate the utility of thi s method for decision makers in various sectors of the health care sys tem, including physicians, pharmacy benefit administrators, formulary committees, and manufacturers. Findings indicate that despite a higher unit cost for ISMO, total anticipated treatment costs with this new l ong-acting nitrate are lower than those associated with ISDN (28%) and nitroglycerin patch (16%) therapy in patients with stable angina, and ISMO requires less dosing titration and is associated with fewer tole rance effects.