The National Institute for Health and Clinical Excellence has issued final draft guidance recommending the use of drug-eluting stents on the National Health Service in patients with coronary heart disease.
Drug-eluting stents are, like their bare-metal counterparts, inserted into narrowed arteries in the heart to help ease blood flow, but have the advantage of slowly releasing a drug to block help prevent the growth of scar-tissue around the stent. Global market leaders currently include: Johnson & Johnson’s Cypher, which is coated with sirolimus; Abbott Laboratories’ everolimus-covered Xcience; and Boston Scientific’s paclitaxel-eluting stent Taxus.
The Institute is recommending that doctors use drug-eluting stents to avoid unnecessary repeated replacements with bare-metal stents, deeming them a cost-effective use of NHS resources provided the price difference between the two types is no more than £300.
According to NICE chief executive Andrew Dillon, the decision was made after careful consideration of all the evidence, with the independent appraisals committee taking into account the “risks and benefits of the different types of stents, and the significant additional costs involved in the use of drug-eluting stents compared to bare-metal stents.“
“We are pleased that NICE has listened to the experts and confirmed that drug eluting stents will continue to be available for certain high risk patients,” commented Professor Peter Weissberg, Medical Director of the British Heart Foundation.
The guidance is now subject to appeal but, provided no objections are received, the Institute says it expects to issue final guidance to the NHS in March.
