OBJECTIVES: Drug eluting stents (DES) are more effective than bare metal stents (BMS) in preventing angiographic and clinical restenosis. Within this study the cost-effectiveness of sirolimus (SES) and paclitaxel eluting stents (PES) compared to BMS was estimated for a UK setting with data from a meta-analysis. METHODS: A probabilistic Markov model was constructed. The model includes events observed in clinical trials (MI, revascularisation, CABG) and the health states heart failure and stroke. The meta-analysis data comprised 3-year follow-up data from randomized controlled trials. Probability distributions were fitted to all transition probability, cost and quality of life (QoL) parameters. Univariate sensitivity analysis was performed on several parameters. Effects and costs were discounted at 3%, the time horizon was 3 years and the number of stents was 1.27 per patient. A health care perspective was adopted. QoL data was obtained from published studies. RESULTS: The incremental costs for SES patients are €712 (95% CI: -2431 - 1715) and €1101 (95% CI: 150 - 1493) for PES patients. DES yield less QALYs than BMS with -0.0156 incremental QALYs (95% CI: -0.2652 – 0.2302) per SES patient and -0.0077 incremental QALYS (95% CI: -0.0777 – 0.06643) per PES patient compared to BMS patients. At a threshold level of Euros 50'000 per QALY the incremental net monetary benefit per SES patient is €-1492 (95% CI: -14213 – 10766) and €-1484 (95% CI: -5004 – 2273) per PES patient. At the same threshold level SES have a 35% probability of being cost-effective, PES have a probability of 17% of being cost-effective. CONCLUSIONS: 3-year follow up data show that DES are less effective than BMS when mortality is taken into account. Given the higher costs per DES patient, DES are dominated by BMS. Althoug DES show favourable results over BMS concerning revascularisation rates, they are not cost-effective.