Study finds drug stents often not cost-effective
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Popular new drug-coated devices to keep arteries open are not cost-effective for many heart patients and their use could be restricted to high-risk groups, researchers said on Tuesday.
The worldwide market for drug-eluting stents—tiny wire-mesh tubes that hold open cleared arteries while dispersing a medicine to prevent re-clogging—is $5.5 billion and growing fast.
They are increasingly being used instead of older bare metal stents.
But an 826-patient Swiss study found that although the newer devices worked better than the older ones, they were not cost-effective because they were more expensive and did not substantially reduce the costs of follow-up patient care.
Overall, the average cost of six months of treatment using a drug eluting stent was 10,544 euros ($13,230), or 900 euros more than for bare stents. Their high initial price was not compensated by lower follow-up costs.
“The use of drug eluting stents could be restricted to certain high-risk patient groups, at least until the prices fall,” said Professor Matthias Pfisterer of the University of Basel, Switzerland.
Those patients most likely to benefit from drug eluting stents included the elderly and people needing multiple or particularly complicated procedures.
Patients requiring a short stent generally fared well with bare metal, he said.
USE RISING FAST
In the United States, drug eluting devices account for more than 80 percent of the stent market and their use in Europe is also growing fast, Pfisterer said.
Clinicians and patients have been attracted to the new products because the medication they are coated with helps stop blood vessels from closing up again.
Pfisterer and his colleagues presented their findings to the European Society of Cardiology congress and the research was also published online by the Lancet medical journal.
The study compared three sets of patients, who were randomly given either Johnson & Johnson’s drug-coated Cypher stent, Boston Scientific Corp’s drug-coated Taxus stent or a bare metal device.
Pfisterer said the Cypher product appeared slightly more effective in preventing cardiovascular complications than the Taxus one, but the difference was not statistically significant.
Johnson & Johnson and Boston Scientific currently dominate the drug-eluting stent market but rivals are now arriving on the scene and Pfisterer said this could help bring down prices in the longer term.
New competitors include Medtronic Inc.‘s Endeavor device, launched in Europe last month, and Sorin SpA’s Janus product, which reported positive six-month clinical trial results at this week’s cardiology conference.
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