OBJECTIVE: The aim of this study was to explore cost and health consequences of using drug eluting stents (DES) instead of bare metal stents (BMS) for patients with stable angina. METHODS: We developed a Markov model which captures costs and outcomes the first two years after PCI with stent for stable angina. After each PCI, patients can become well, have a new intervention (PCI og CABG) or die. The model was based on meta-analyses of trials comparing DES with BMS. These trials indicate that the use of DES reduces the need for repeat revascularisation by 36% to 86%. We assumed that DES will reduce mortality because of fewer intervention related deaths, but also explored a potential increased mortality because the meta-analysis indicates a non-significant trend towards increased mortality of DES compared to BMS. One-way and Monte-Carlo sensitivity analyses were applied. RESULTS: The estimated cost per avoided reintervention was $5,000 when BMS was replaced by DES, ranging from $200 to $16,000 in one-way sensitivity analyses. The price of a drug eluting stent would have to be reduced from currently $2000 to $1400 to make the use of DES cost saving compared to BMS (current purchasing price $560). The estimated cost per life year gained and quality adjusted life year gained were $121,000 and $46,000, respectively, when increased mortality was disregarded in the model. Probabilistic sensitivity analysis indicated a 64% probability that drug eluting stents were cost-effective if society is willing to pay $50,000 for one quality adjusted life year. When the increased mortality was included, BMS was the dominant strategy, with both lower costs and greater life expectancy. CONCLUSIONS: The cost-effectiveness of DES depended heavily on purchasing price of the stents and rate of reintervention in routine practice and may not be cost-effective at current price level.