title: [Second-generation DES : New, but also cost-effective?].
abstract: BACKGROUND
  The objective of the present review was to investigate the cost-effectiveness of second-generation drug-eluting stents (DES) compared to bare metal stents (BMS) as well as to first-generation DES.
  
  
  METHODS
  A structured literature review in MEDLINE was conducted to identify all studies investigating the cost-effectiveness of second-generation DES published up to December 2010. Pre-specified selection criteria were applied to identify relevant studies. Standardized data extraction was performed to summarize clinical, economic, and cost-effectiveness outcomes of these studies.
  
  
  RESULTS
  Of only five studies which met all selection criteria from the US, UK, and Spain, three investigated the cost-effectiveness of the zotarolimus-coated Endeavor stent (ZES) compared to BMS, and two studies the ZES with first-generation DES.
  
  
  CONCLUSIONS
  In summary, there is currently a lack of evidence with regard to the cost-effectiveness of second-generation DES, especially in Germany. However, studies from other countries provide some evidence that second-generation DES appear to generally not be cost-effective compared to BMS. Also, there is no conclusive evidence of cost-effectiveness compared to first-generation DES. Moreover, there are currently no studies investigating the cost-effectiveness of the Everolimus-coated Xience V stent. Methodologically rigorous economic evaluations addressing these issues within the context of the German health care system are therefore urgently required.
authors.affiliation: Institut für Sozialmedizin, Epidemiologie und Gesundheitsökonomie, Charité - Universitätsmedizin Berlin, Deutschland. falk.mueller-riemenschneider@charite.de
authors.forename: F
authors.initials: F
authors.lastname: Müller-Riemenschneider
authors.forename: T
authors.initials: T
authors.lastname: Reinhold
authors.forename: S N
authors.initials: SN
authors.lastname: Willich
mesh_terms: D003324:Coronary Artery Disease / Q000188:drug therapy* / Q000191:economics* / Q000453:epidemiology; D003362:Cost-Benefit Analysis; D054855:Drug-Eluting Stents / Q000191:economics* / Q000706:statistics & numerical data*; D005343:Fibrinolytic Agents / Q000627:therapeutic use*; D005858:Germany / Q000453:epidemiology; D017048:Health Care Costs / Q000706:statistics & numerical data*; D006801:Humans; D015995:Prevalence
chemical_list: D005343:Fibrinolytic Agents