OBJECTIVES: An ongoing 2-year local prospective study to compare clinical, humanistic and economic outcomes of Drug Eluting Stents (DES) and Bare Metal Stents (BMS). METHODS: All patients receiving DES or BMS placement in Prince of Wales Hospital in Hong Kong within the period of September 2009 to March 2010 were recruited and followed for 12 months. Clinical outcome was measured by occurrence of major adverse cardiac events (MACE). EQ-5D questionnaire, with visual analog scale (VAS), was used to assess patients’ health-related quality of life. The questionnaire was administered by patients before procedure, at 6 month and 12 month. Cost of index procedure and follow-up were recorded and cost per QALY of DES over BMS was used to evaluate cost-effectiveness of DES. Subgroup analysis was performed on patients with diabetes mellitus (DM). RESULTS: 325 patients were enrolled (n=210 for DES and n=115 for BMS), with balanced baseline characteristics. MACE was significantly less common in DES group (n=10, 4.8% vs n=14, 12.2%; OR=0.361, 95% Cl=0.155 to 0.841). The increase in utility score at 12 month was 0.22 for DES group and 0.17 for BMS group (p=0.294). Aggregate 12-month cost was higher in DES group (HK$110,640 68,706 vs HK$99,802 93,420; p=0.235). Cost per QALY gained for DES was HK$184,564. Subgroup analysis showed that cost per QALY was HK$15,303 in DM patients. Subsidizing DM patients to use DES, instead of BMS, could save up to HK$6,370,000 annually for Hospital Authority. (1US$ = 7.8 HK$) CONCLUSIONS: DES was shown to be superior to BMS in clinical outcome. Even with higher procedural cost in DES group, the lower follow-up cost resulted in gradually smaller difference in aggregate cost. DES was more cost-effective than BMS, especially in DM patients. Subsidizing DM patients to use DES would be cost-saving and lead to better clinical outcome.