After Rapid Growth, Use of Drug-Eluting Stents Levels Off;
Volume of PCIs Stabilizes While AMIs Decline

After a two-year period of rapid adoption by hospitals, use of drug-eluting stents (DES) appears to be leveling off, according to new research from Solucient®. Despite this development, the overall volume of inpatient percutaneous coronary intervention (PCI) procedures has stabilized while, as forecasted, the number of acute myocardial infarction (AMI) cases has declined.

First approved for use by the Food and Drug Administration in the second quarter of 2003, DES were being used in 90 percent of PCIs involving some type of stent by the fourth quarter of 2005. In fact, more than 570,000 procedures involving DES were performed in 2005.

Solucient's analysis also found that overall inpatient volume of all PCI procedures in 2005 was 669,200, only slightly higher (approximately 5 percent) than volume prior to the introduction of drug-eluting stents. This indicates that the introduction of DES has primarily caused a shift in the type of stent used, rather than a change in the number of patients receiving a PCI procedure.

However, as anticipated, DES use appears to have impacted the number of AMI cases. Earlier research predicted that the introduction of drug-eluting stents would cause the number of AMI admissions to decline below the 2002 level for at least six years. Solucient data shows a continual decrease in admissions for AMI since 2002; dropping approximately 10.7 percent from 2002 to 2005. The predicted decline was based on information from Solucient's Market Impact Modeler, an Internet-based solution that forecasts the impact of new technologies on patient volumes over the next 15 years. Solucient's empirical research confirmed the decline.

According to the data, AMI admissions are now at a lower level than originally estimated. The minimum number of admissions forecasted was approximately 646,000 versus 641,000 actual AMI admissions in 2005. This greater than expected decrease in the number of AMIs may be partially due to other factors, particularly the increased use of statins, which have been shown to reduce the rate of coronary events. Statins are used to lower cholesterol levels in people at risk for cardiovascular disease.

Data for this research was provided by Solucient's ACTracker®, an online application that provides drug and product utilization trends across a hospital setting, and projected inpatient databases.