Clinical and cost-effectiveness analysis of drug eluting stents compared to bare metal stents for percutaneous coronary interventions in Ontario

The objectives of the study are twofold (1) To estimate the reduction in the risk of repeat revascularization associated with the use of DES, relative to BMS, among patients at high risk of restenosis; and (2) Combining the data from the registry study with costs and other published evidence, to estimate the net cost and cost- effectiveness of percutaneous coronary interventions (PCI) with DES, re [...] Subsequent randomized trials have shown restenosis rates of less than 10% in the DES arm as compared to >30% in the BMS arm.3-6 Although, randomized trials comparing DES with standard BMS have shown relative risk reductions for restenosis of 90% - 100% in patients with selected lesions and 60-75% in patients with a broader range of lesions, the benefit to patients of reduced risk of repeated PCIs [...] CCN Working Group on Drug Eluting Stents Following the completion of the initial evaluation of DES by the Medical Advisory Secretariat, the MOHLTC requested that the Cardiac Care Network of Ontario (CCN) coordinate a brief report from the interventional cardiac centres in the province to discuss the anticipated scope and target population for the targeted use of DES.13,14. [...] DES utilization in Ontario The widespread use of DES in Ontario commenced in September 2003 following the annual funding approval by the Ministry of Health and Long-Term Care. [...] The condition of this funding was that the Cardiac Care Centres assist in the collection of data to allow for a Ministry of Health and Long-Term Care sponsored Health Technology Assessment (HTA) of DES to be conducted by the Program for Assessment of Technology in Health (PATH).