Recent studies examining the effectiveness of drug-eluting stents ( @entity4743 ) have found that the use of @entity4743 is associated with a significant increase in the incidence of late stent @entity715 (LST). Previous cost-effectiveness analyses of @entity4743 have not accounted for the costs associated with LST. In this study, published research was reviewed to identify studies that compared the cost-effectiveness of @entity4743 with that of bare-metal stents and to identify the incidence of LST. Probable costs were assigned to LST-related @entity583 and @entity204 on the basis of the treatment costs for these outcomes. These costs as well as those of extended @entity1397 therapy were then incorporated into the @entity3446 -Eluting Balloon Expandable Stent in the Treatment of @entity1 With De Novo Native Coronary Artery Lesions (SIRIUS) and TAXUS-IV cost-effectiveness data. This review found that the incidence of LST ranged from 0.2% to 0.7%. Assuming a base case LST incidence of 0.5%, a cost per @entity204 of  20,000, a cost per @entity583 of  20,000, and a cost of an additional 2 years of @entity1397 therapy of  2,428 per @entity1 , the costs per revascularization avoided were  15,056 for the SIRIUS trial and  25,210 for the TAXUS-IV trial. The costs per quality-adjusted life-year gained were  250,935 and  257,591, respectively. Sensitivity analyses revealed that the costs per revascularization avoided varied from  14,618 to  15,830 for the SIRIUS trial and from  24,540 to  26,396 for the TAXUS-IV trial. Similarly, the cost per quality-adjusted life-year gained varied from  243,638 to  263,840 for the SIRIUS trial and from  250,739 to  269,708 for the TAXUS-IV trial. In conclusion, LST-related adverse events and the need for extended @entity1397 therapy substantially increase the costs associated with the implementation of @entity4743 . The inclusion of these costs renders the widespread use of @entity4743 not cost effective in the United States in terms of cost per quality-adjusted life-year gained and cost per revascularization avoided.

Cost-effectiveness of drug-eluting stents including the economic impact of late stent XXXX .

@entity1 :: ('9606', 'Species') :: ['Patients', 'patient'] @entity583 :: ('MESH:D009203', 'Disease') :: ['myocardial infarction'] @entity1397 :: ('MESH:C055162', 'Chemical') :: ['clopidogrel'] @entity4743 :: ('CHEBI:37628', 'Chemical') :: ['DES'] @entity3446 :: ('MESH:D020123', 'Chemical') :: ['Sirolimus'] @entity715 :: ('MESH:D013927', 'Disease') :: ['thrombosis'] @entity204 :: ('MESH:D003643', 'Disease') :: ['death']
@entity715 :: (MESH:D013927,Disease) :: ['thrombosis']
