Heart 2008;94:1646-1648
TECHNOLOGY AND GUIDELINES
NICE guidelines for the use of drug-eluting stents: how do we establish worth?
Dr M A de Belder, The James Cook University Hospital, Marton Road, Middlesbrough TS4 3BW, UK; mark.debelder@stees.nhs.uk
Accepted 12 August 2008
| The first 150 words of the full text of this article appear below. |
The introduction of new healthcare technologies requires an appropriate discourse between clinicians who identify problems to be overcome and industrial partners who provide potential solutions. New products go through a tight regulatory process before they can be widely used. Although this process is somewhat different for medical devices than for drugs, the principles are the same: demonstration of proof of principle and safety, and identification of patients most likely to benefit. However, their use nowadays depends as much on a demonstration of cost effectiveness as on clinical effectiveness. Cost-effectiveness analysis requires quantification of both clinical effect and overall costs of different treatments.
In the UK the balance between clinical effectiveness and cost effectiveness is determined by the National Institute of Health and Clinical Excellence (NICE). NICE has just published its updated technology appraisal following its latest review of the use of drug-eluting stents (DES), and reaffirms that these products should
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