Drug-eluting stents: from evidence to policy.
Drug-eluting stents are a major breakthrough in cardiology, with the Cypher (Cordis Corporation) and Taxus (Boston Scientific) stents preventing 60-70% of repeat coronary revascularizations, compared with bare metal stents. Both evidence- and risk-based application of drug-eluting stents is expected to create relevant financial and equity problems to most public hospitals, as the cost of drug-eluting stents is over 1000 higher than traditional stents. In the perspective of third-party payers, drug-eluting stents are cost-effective revascularization strategies for a large portion of patients actually undergoing stenting. However, adequate guidelines and reimbursement strategies are still awaited in several countries.
Marchetti
Monia
M
Laboratory of Medical Informatics, IRCCS Policlinico S.Matteo, viale Golgi 19, 27100 Pavia, Italy. marchettim@smatteo.pv.it
D001807:Blood Vessel Prosthesis; D002986:Clinical Trials as Topic; D016503:Drug Delivery Systems / Q000295:instrumentation / Q000379:methods; D004343:Drug Implants / Q000627:therapeutic use*; D019317:Evidence-Based Medicine; D006083:Graft Occlusion, Vascular / Q000517:prevention & control*; D007166:Immunosuppressive Agents / Q000008:administration & dosage*; D011474:Prosthesis Design; D011640:Public Policy; D015607:Stents; D016896:Treatment Outcome
D004343:Drug Implants; D007166:Immunosuppressive Agents