Evaluación económica de stents coronarios en pacientes con infarto del miocardio con elevación del ST en Colombia: un paso hacia la implementación de políticasControl of health care expenditure remains one of the most significant challenges many countries in the world are currently facing given its potential to disrupt the provision of basic health care services within the next decade. As seen in this graphic from the World Bank ( Fig. 1), health expenditure per capita in Colombia has followed the same upward trend seen in most developed and developing countries. 1 Since cardiovascular disease remains the leading cause of morbidity and mortality, any large scale interventions will have a significant impact in healthcare budgets.Cost-effectiveness analysis is a tool which provides different costs associated with health outcomes, compares costs of treatment alternatives and assesses which alternative is worth the cost. This information will provide policy makers elements for allocation decisions. The goal is to get the most out of the existing and projected financial resources.Quality-adjusted life year, or QALY, reflects how many years of high-quality life a patient gains with a particular intervention. Another parameter used to measure value is DOI of original article: http://dx.the cost-effectiveness ratio. It is the price of buying more healthy years with a new treatment compared with the standard treatment, and whether it is a good value.The World Health Organization has a rule of thumb: Three times per-person income per quality-adjusted life year gained is a cost-effective intervention.To make further progress in health, meet new challenges, and redress inequities, resources must be deployed effectively. This requires knowledge about which interventions actually work, information about how much they cost, and experience with their implementation and deliveryIn this issue of the Revista Colombiana de Cardiología, M. Ceballos-González 2 published an elegant cost effectiveness analysis of drug eluting stents (DES) compared to bare metal stents in patients with ST elevation myocardial infarction (STEMI) in Colombia. His analyses included actual costs, projected costs, probability determinations as well as many others calculations which are rather difficult to translate into clinical language. The main conclusion however, was that Sirolimus-eluting stents are not cost effective for patients with ST elevation myocardial infarction in Colombia.It is important to remember that this analysis is circumscribed to STEMI patients and does not apply to elective or semi elective interventions. Prevalence has a large effect on the cost-effectiveness analysis. For example, screening and http://dx.