Resource impact summary report
Resource impact summary report
Recommendations
NICE has recommended that there is not enough evidence comparing drug-eluting stents to determine whether price variation between different stents is justified.
NHS trusts should provide access to a range of drug-eluting stents, so that a clinically appropriate stent is available for everyone with coronary artery disease.
If more than one drug-eluting stent is clinically appropriate, choose the least expensive stent.
Eligible population
There are around 1.7 million people living with coronary heart disease in England (based on NHS England's 2023 to 2024 Quality and Outcomes Framework prevalence estimates and Office for National Statistics population estimates). According to NHS England's Spend Comparison Service data which uses data reported by providers, cited in a GIRFT (Getting It Right First Time) cardiology report, in 2021 the NHS spent over £21 million on nearly 86,000 drug-eluting coronary stents in England.
Treatment options
The current management of coronary artery disease and using drug-eluting stents is from the following sources:
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Byrne RA, Rossello X, Coughlan J et al. (2023) European Society of Cardiology (ESC) Guidelines for the management of acute coronary syndromes. European Heart Journal 44(38): 3,720–3,826
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Vrints C, Andreotti F, Koskinas K et al. (2024) ESC Guidelines for the management of chronic coronary syndromes. 45(36): 3,415–3,537
In 2023, around 65% of the spend on drug-eluting stents within the NHS was directed through the NHS Supply Chain. The clinical experts explained that contracts for stents at NHS trusts typically include 2 or 3 drug-eluting stents that can be used across various types of lesions. A small proportion (for example, 10%) of the contract is reserved for purchasing stents for use in specific cases.
Financial resource impact (cash items)
Around 86,000 stents were used in the NHS in 2021 at a cost of over £21 million (GIRFT cardiology report).
Choosing the least expensive stent if more than one drug-eluting stent is clinically appropriate may save costs. But the potential savings are uncertain. This is because price differences between stents are generally relatively small. They are variable at a local level and would depend on local procurement policies.
Capacity impact
No capacity impact has been identified because no particular stent is recommended over another.
Key information
Table 1 Key information| Speciality area |
Cardiology |
|---|---|
| Disease area |
Coronary heart disease |
| Programme budgeting category |
PBC10A – coronary heart disease |
| Pathway position |
Disease management |
| Commissioner(s) |
Integrated care boards |
| Provider(s) |
Secondary care – acute and tertiary |
About this resource impact summary report
This resource impact summary report accompanies the NICE guidance on drug-eluting stents for treating coronary artery disease and should be read with it.
ISBN: 978-1-4731-7006-3
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