Cost-Effectiveness of Drug Eluting Stents Versus Bare Metal Stents in Coronary Heart

Diana Cristina Carrillo, María Clara Ortiz Sierra, Magda Cristina Cepeda Gil, Cesar Augusto Guevara Cuellar



The purpose of this study was to perform a systematic literature review to determine whether coronary disease endovascular

therapy with drug eluting stents (DES) compared with bare metal stents (BMS) is cost-effective.


A systematic review was performed in Pubmed/Medline, Embase, CDRS, NCBI, Hinari, CRD, DARE, NHSEED, HTA,

HSRPROJ, HSTAT electronic databases to identify full economic evaluation studies with health care perspective reporting

the relationship between cost/absolute risk reduction and cost/QALY, without date or language limitations.


Sixteen studies were included (21807 participants). Paclitaxel or sirolimus DES compared with BMS were evaluated in five

studies (31.25%), 31.25% assessed only sirolimus eluting stents, 25% only paclitaxel eluting stents and 12.5% zotarolimus

eluting stents. Health care payment perspective was explicit in 93.75% of the studies. The distribution of patient characteristics was similar in all groups and balanced in observational studies. Six of the 16 studies concluded that DES were not cost-effective in their population, but that in subgroups at greater risk of restenosis or with multiple vessel disease the therapy was cost-effective.


The studies were consistent in the reduction of target vessel revascularization frequency with DES compared

to BMS without affecting mortality at 12 month follow-up. The intervention was cost-effective in studies at greater risk of restenosis or with multiple vessel disease.


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