Introduction
- Drug-eluting stents have become the gold standard in PCI procedures; it is up for debate as to whether biodegradable stents become the future gold standard. The debate about PCI vs thrombolysis still continues, however opinion seems to be falling firmly on the side of PCI.
Scope of this report
- Market overview and review of the rise of drug eluting stents to gold-standard status, with an update on clinical trials and reimbursement status
- Identify the key players in the PCI drug-eluting stent market and understand how this is likely to change with the advent of biodegradable stents
- Follow the debate on PCI vs. thrombolysis and understand why opinion leaders seem to favor PCI
- Understand the critical issue around time-to-needle and remote transfer
Research and analysis highlights
- The drug-eluting stent seems to be the device for the future by solving (and promising to solve) one of the largest problems of interventional coronary treatment: restenosis. Opinion leaders interviewed by Datamonitor in 2004 suggest that the use of drug-eluting stents has reached 9095% of the stent market both in the US and Europe.
- It is now thought that even with the additional delay, transfer of patients for PCI is associated with better outcomes than treating with thrombolysis at the local hospital.
- When primary PCI cannot be provided readily and transfer is necessary, intravenous thrombolysis may be a better choice for patients seen early (within the first two hours), especially if it can be provided in a pre-hospital setting. This does not preclude subsequent transfer to an interventional center.
Key reasons to read this report
- Understand the reasons for the success of drug-eluting stents and their rise to becoming the gold-standard treatment
- Identify the key players in the PCI drug-eluting stent market and understand how the market will evolve with the advent of biodegradable stents
- Understand why opinion leaders seem to favor PCI over thrombolysis and the critical issue around time-to-needle and remote transfer
ABOUT DATAMONITOR HEALTHCARE
- About the Cardiovascular pharmaceutical analysis team
EXECUTIVE SUMMARY
- Introduction
- Scope and coverage of this Brief
- Key findings about the topic
PERCUTANEOUS CORONARY INTERVENTION MARKET DYNAMICS
- The PCI market
- Evolution to drug-eluting stents
- Success of the drug-eluting stent
- Cost effectiveness of drug-eluting stents
- The drug-eluting stent gold standard
- Cypher
- Taxus
- Latest clinical trial update
- Taxus
- Cypher
- Safety and side-effect issues with drug-eluting stents
- Stents and the use of adjunctive therapy
- Reimbursement update
- UK
- France
- Belgium
- New entrants
- Biodegradable stent technology
- Future market
PCI VS. THROMBOLYSIS
- PCI is the way forward
- Time-to-needle
- Remoteness and transfer time
- Pre-hospital thrombolysis: the next step?
- New developments
- Conclusion
APPENDIX
- Contributing experts
- Bibliography
- Other Clinical Data
- Research methodology
- Disclaimer
- List of Tables
- Table 1: Comparison of cost of bare-metal and drug-eluting stents
- Table 2: Drug-eluting stents marketed or in development
- Table 3: Price comparisons of adjunctive therapies
- List of Figures
- Figure 1: Advances in PCI have improved patient outcomes (US data)
- Figure 2: Drug-eluting stents have further improved patient outcomes
- Figure 3: Breakdown of treatment time and mortality rate
