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(Circulation. 2004;110:472-474.)
© 2004 American Heart Association, Inc.

Editorial

Economics of Sirolimus-Eluting Stents

Drug-Eluting Stents Have Really Arrived

William S. Weintraub, MD

From Emory University, Atlanta, Ga.

Correspondence to William S. Weintraub, MD, Emory Center for Outcomes Research, Emory University, Briarcliff Campus, Atlanta, GA 30322. E-mail wweintr@emory.edu

Key Words: Editorials • stents • drugs

An extract of the first 250 words of the full text is provided, because this article has no abstract.

Since the development of coronary angioplasty in the late 1970s, there have been a series of technical advancements that have improved the outcome of the procedure. Clearly, the biggest advance was to move from balloon angioplasty to intracoronary stenting and now to drug-eluting stents (DES).^1,2 These advances have been shown to reduce in-hospital events and to dramatically lower the incidence of restenosis, the long standing "Achilles’ Heel" of percutaneous coronary intervention (PCI). As these advances have occurred, there has been concern about the ability of society to afford these new therapies.

See p 508

What we seek in medical care is value; that is, good medical care that is worth what we pay for it. This may be evaluated for a particular new service, whether diagnostic or therapeutic, by performing a cost-effectiveness evaluation. Healthcare economics has grown as a field in recent years, and there are now published standards for cost-effectiveness evaluations.³ The cost-effectiveness of a new procedure is best expressed in cost per quality adjusted life year (QALY) gained.³ More recently, economic studies have been conducted as part of randomized controlled trials.⁴ This offers the ability to both get patient level as opposed to summary data and also to benefit from a randomized comparison. Economic evaluations benefit from the lack of selection bias in randomized trials just as much as clinical comparisons do.

A model economic evaluation performed as part of the randomized trial of DES, the Sirolimus-Eluting Balloon Expandable Stent in the Treatment of Patients With De Novo . . . [Full Text of this Article]

Related Article:

Cost-Effectiveness of Sirolimus-Eluting Stents for Treatment of Complex Coronary Stenoses: Results From the Sirolimus-Eluting Balloon Expandable Stent in the Treatment of Patients With De Novo Native Coronary Artery Lesions (SIRIUS) Trial

David J. Cohen, Ameet Bakhai, Chunxue Shi, Louise Githiora, Tara Lavelle, Ronna H. Berezin, Martin B. Leon, Jeffrey W. Moses, Joseph P. Carrozza, Jr, James P. Zidar, Richard E. Kuntz on behalf of the SIRIUS Investigators
Circulation 2004 110: 508-514. [Abstract] [Full Text]

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