A shift in the use of drug-eluting stents in Australian private hospitals

Suzanne M McLean and David J Clark
Med J Aust 2008; 188 (2): . || doi: 10.5694/j.1326-5377.2008.tb01548.x
Published online: 21 January 2008

To the Editor: Drug-eluting coronary stents (DES) were approved for use in Australia in 2002, after they were found to be effective in limiting the incidence of restenosis.1 However, their cost is three to four times that of traditional bare-metal stents, and most Australian states restricted their use in the public health system. In 2006, we reported in the Journal that DES were used in 45% of patients undergoing percutaneous coronary intervention (PCI) in Victorian public hospitals, and that they were largely reserved for patients with risk factors for restenosis, such as diabetes, small vessels, and complex lesions.2 However, in the private health system, DES can be claimed as prostheses from insurance funds, so their use is not limited by financial constraints.

  • Department of Cardiology, Warringal Private Hospital, Melbourne, VIC.


  • 1. Moses JW, Leon MB, Popma JJ, et al; SIRIUS Investigators. Sirolimus-eluting stents versus standard stents in patients with a stenosis in a native coronary artery. N Engl J Med 2003; 349: 1315-1323.
  • 2. Yan BP, Ajani AE, Duffy SJ, et al; MIG Investigators. Use of drug-eluting stents in Victorian public hospitals. Med J Aust 2006; 185: 363-367. <MJA full text>
  • 3. Stone GW, Moses JW, Ellis SG, et al. Safety and efficacy of sirolimus- and paclitaxel-eluting coronary stents. N Engl J Med 2007; 356: 998-1008.
  • 4. Harper RW. Drug-eluting coronary stents — a note of caution. Med J Aust 2007; 186: 253-255. <MJA full text>
  • 5. Grines CL, Bonow RO, Casey DE Jr, et al. Prevention of premature discontinuation of dual antiplatelet therapy in patients with coronary artery stents: a science advisory from the American Heart Association, American College of Cardiology, Society for Cardiovascular Angiography and Interventions, American College of Surgeons, and American Dental Association, with representation from the American College of Physicians. J Am Coll Cardiol 2007; 49: 734-739.


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