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© The European Society of Cardiology 2005. All rights reserved. For Permissions, please e-mail: journals.permissions@oxfordjournals.org

New and old strategies to afford the liberal use of drug-eluting stents in real-life scenarios

Marco Valgimigli1,2,3,*, Gianfranco Percoco1,2, Giordano Cicchitelli1,2, Gianluca Campo1,2, Elisa Gardini1,2, Luca Pellegrino1,2, Patrizia Malagutti1,2, Cristina Giretti4 and Roberto Ferrari1,2

1University of Ferrara, Italy
2Cardiovascular Research Centre, Salvatore Maugeri Foundation, IRCCS Gussago (BS), Italy
3Erasmus Medical Center, Thoraxcenter, Rotterdam, The Netherlands
4Health Economics, Johnson & Johnson, Cordis Corporation, Italy

* Corresponding author. Tel: +39 0532 202143; fax: +39 0532 241885. E-mail address: vlgmrc{at}unife.it

Drug-eluting stents represent one of the most important improvements in interventional cardiology by decreasing the rate of restenosis dramatically. However, at present, cost constraints and a lack of incremental reimbursement have limited their utilization in daily practice in many countries, including Europe. Strategies to implement the liberal use of sirolimus-eluting stents (SES), especially in the primary percutaneous coronary intervention setting where the cost-effectiveness profile could be less favourable, without affecting medical expenditure are presented and discussed. To project the potential cost-effectiveness of SES-supported multivessel treatment compared with that of coronary artery bypass grafting, a decision- analytical model was developed from a payer's perspective on the basis of data derived from the current Italian health-care system.

Key Words: Drug eluting stent • Glycoprotein IIb/IIIa inhibitors • Cost-effective


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