Authors' objectives:

This report addresses the safety, effectiveness and cost-effectiveness of drug-eluting stents for the treatment of single de novo lesions in coronary arteries. This review does not seek to determine whether one type of drug-eluting stent is superior to another.

Authors' recommendations: MSAC found that on the strength of current evidence regarding drug-eluting stents: - The technology is as safe as bare metal stents for the treatment of de novo atherosclerotic lesions of the coronary arteries at up to one year post-procedure. - The technology is more effective than bare metal stents in reducing the rates of revascularisation procedures at up to one year. - There is insufficient evidence at this time to demonstrate a difference in the rates of myocardial infarction, coronary artery bypass grafting or mortality in patients receiving this technology compared to those receiving bare metal stents. - There is some evidence that the technology is more effective than bare metal stents in reducing the rates of revascularisation at up to one year in patients with diabetes, long lesions greater than 18mm and small vessels less than 2.5mm. However there is insufficient evidence at this time to demonstrate any additional benefit in these and other subgroups of patients at high risk of stent restenosis. - Cost-effectiveness is based on de novo single vessel lesions. - On the basis of trial data alone, the technology is cost-effective if a cost of $3,700- $6,200 is considered acceptable to avoid a target lesion revascularisation. However a sensitivity analysis to estimate the cost-effectiveness in Australian clinical practice indicates that the cost per target lesion revascularisation avoided may be higher than this figure. Australian clinical practice data is required to resolve this uncertainty.

Authors' methods: Systematic review

Project Status: Completed

URL for project: http://www.msac.gov.au/reports.htm

Year Published: 2005

English language abstract: An English language summary is available

Publication Type: Not Assigned

Country: Australia

Organisation Name: Medical Services Advisory Committee

Contact Address: MSAC (MDP 107), GPO Box 9848, Canberra, ACT 2601, Australia. Tel: +61 2 6289 6811; Fax: +61 2 6289 8799.

Contact Name: msac.secretariat@health.gov.au

Contact Email: msac.secretariat@health.gov.au

Copyright: Medical Services Advisory Committee (MSAC)