Cost Effectiveness of Drug Eluting Stents

Drug eluting stents (DES) have ushered in a new era in non-surgical coronary revascularization with substantially reduced rates of restenosis, albeit at an increased expense for our health care system incurred by their higher cost compared to bare metal stents (BMS) and by a high demand of these devices by both physicians and patients. The risk of late thrombosis and other safety issues will need to be further investigated. The cost-effectiveness of DES depends on the features of the target population, the higher DES cost, any remaining safety issues and the specific treatment comparator (BMS, surgical or medical therapy). According to the data of economic analyses and clinical trials, DES will be reasonably cost-effective for a great percentage of patients and even cost saving for the subgroup of patients who are at high risk of clinical restenosis with the conventional PCI techniques. The main limitation of wider application of DES in the daily interventional practice remains their high price, which if lowered in the future will broaden their target population in interventional cardiology