National Institute for Health and Clinical Excellence (NICE)
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NICE appraisal of drug-eluting stents for the treatment of coronary artery disease

NICE last week published its final draft guidance on the use of drug-eluting stents for the treatment of coronary artery disease (CAD). This is a part review of guidance on the use of coronary artery stents published in October 2003. The draft guidance recommends the use of drug-eluting stents (DES) for those patients who are at higher risk of needing further stents if a conventional bare-metal stent (BMS) were used instead. These patients have a coronary artery less than 3mm in diameter, or the segment of the artery to be treated is longer than 15mm. The draft guidance also states that drug eluting stents should only be used if the price difference between it and a bare metal stent is no more than £300. This draft guidance has been issued to stakeholders to consider whether they wish to appeal against the recommendations; it has not yet been issued as guidance to the NHS. The appeal period ends on 15 February 2008.

Andrew Dillon, NICE Chief Executive, said: “This decision to recommend the use of drug-eluting stents for patients was reached by a careful consideration of the evidence, 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The draft guidance is available (from 00:01 on 1 February) for information on the NICE website at http://www.nice.org.uk/guidance/index.jsp?action=byID&o=11706. Assuming no appeals

Notes to Editors

About NICE


1.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.

2.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.

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