OBJECTIVES: To evaluate clinical and economic benefit of Drug Eluting Stents (DES) in comparison with Bare-Metal Stents (BMS) and surgical treatment with coronary artery bypass graft (CABG) for Sicily Regional Government. METHODS: Cost-effectiveness analysis was carried out by two decision models: patients treated with DES vs. BMS. Cost was carried out from the point of view of the SSR (Servizio Sanitario Regionale, Regional Health Service). RESULTS: The use of DES generated unitary differential savings of €9,003, after 9 months of follow-up, and total differential savings of €4,114,371. The use of DES on patients destined to BMS gave average unitary differential savings of €1,075, after 9 months of follow-up, and average total differential savings of €927,875. The use of DES instead of BMS and CABG allowed SSR to make average differential savings of €3,735 per successful case. A total of €2476 represent the refund threshold value of DES, setting to zero the SSR average differential savings for patients treated with DES who would otherwise have been treated with BMS. CONCLUSION: Results of the proposed models, tested with sensitivity analysis, demonstrate the use of DES to be justified; moreover, these results could positively influence the attitude of the SSR towards these new therapeutic strategies, which are an improvement on standard therapies, both from a clinical and a financial standpoint.