NICE Issues Guidance On The Use Of Drug-Eluting Stents For The Treatment Of Coronary Artery Disease

Main Category: Cardiovascular / Cardiology
Article Date: 29 Jul 2008 - 14:00 PDT

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NICE has published its final guidance on the use of drug-eluting stents for the treatment of coronary artery disease. This is a part review of guidance on the use of coronary artery stents published in October 2003. Publication of this appraisal follows a meeting of the Appeal Panel on 31 March 2008, which heard an appeal from stent manufacturer Cordis. This appeal was not upheld by the Appeal Panel.

The guidance recommends the use of drug-eluting stents for those patients who are at high risk of requiring further interventions if a conventional bare-metal stent was used instead. Such patients have a coronary artery less than 3mm in diameter, or the segment of the artery to be treated is longer than 15mm. The guidance also states that drug eluting stents should only be used if the price difference between it and a bare metal stent is no more than £300.

Andrew Dillon, NICE Chief Executive, said: "We are aware, both from industry and from the NHS, that the maximum price difference between a drug eluting stent and a conventional bare metal stent allowed for in our guidance is available already in some NHS hospitals and achievable for the rest of the NHS. Therefore, this decision to recommend the use of drug-eluting stents will ensure that, despite their higher cost, they will continue to be an important treatment option for patients who would be at high risk of requiring further interventions if a bare-metal stent was used instead. The guidance is the result of careful consideration of the evidence, as well as comments received during consultation and further economic modelling. The independent Appraisal Committee took 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."

The guidance is available on the NICE website at http://www.nice.org.uk/TA152.

About NICE

The National Institute for Health and Clinical Excellence (NICE) is the independent organisation responsible for providing national guidance on the promotion of good health and the prevention and treatment of ill health.

NICE produces guidance in three areas of health:

- Public health - guidance on the promotion of good health and the prevention of ill health for those working in the NHS, local authorities and the wider public and voluntary sector

- Health technologies - guidance on the use of new and existing medicines, treatments and procedures within the NHS

- Clinical practice - guidance on the appropriate treatment and care of people with specific diseases and conditions within the NHS.

http://www.nice.org.uk