Drug stents not good value for many patients: study

By Ben Hirschler

LONDON (Reuters) - Expensive drug-coated stents -- used to prop open clogged coronary arteries -- are not worth using in many patients, Swiss researchers said on Friday.

The devices can, however, be cost-effective in a subset of heart patients who have particularly narrow vessels.

Their findings from an 18-month study of 826 patients paint a less favorable value-for-money picture than previous research and will stoke fresh controversy over when to use drug stents.

It comes just days before a key review of the cost-effectiveness of the devices by Britain's National Institute of Health and Clinical Excellence (NICE).

NICE alarmed manufacturers in August with an initial proposal that drug stents were not worth using on the state health service. The watchdog's appraisal committee will meet to draw up its final draft recommendations on November 6, though the decision will not be made public for several weeks.

Stents are a multibillion-dollar business for companies like Boston Scientific and Johnson & Johnson, who make the two drug-eluting stents assessed in the Swiss study.

The devices are designed to prevent arteries re-narrowing as often happens with bare metal stents, but their use has dropped recently because of fears that deadly blood clots can form inside the devices in rare cases.

"If used in all patients, drug-eluting stents are not good value for money, even if prices were substantially reduced," Matthias Pfisterer, of Basel's University Hospital, and colleagues wrote in the Lancet journal.