Author Affiliation: Department of Medicine, University of Washington School of Medicine, Seattle.
We strongly agree that quality, cost savings, and comparative effectiveness are critically important elements for the future of interventional cardiology and for our health care system. The use of drug-eluting stents (DESs) off label should not be equated to inappropriate care, as Dr Redberg has suggested in her Editor's Note in the article by Groeneveld et al.1 The application of therapy should be based on the evidence, only a small portion of which is typically based on the Food and Drug Administration–labeled indications for a device or drug. To diminish the life-saving properties of percutaneous coronary intervention (PCI) and DESs is misguided and a disservice to the patients whose lives have been saved, whose quality of life has been improved, and who will benefit in the future from DESs and other interventional therapies.
Dean LS. Cardiovascular Device Technology and Health Care Cost. Arch Intern Med. 2011;171(18):1689. doi:10.1001/archinternmed.2011.464