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Danis Stent: NICE Medical Technology Appraisal

It’s about Variceal Haemostasis

Originally launched in the UK in 2008 Danis has seen steady growth over recent years within the NHS. However, effective prophylactic treatment and the perceived cost of Danis in comparison to balloon tamponade, coupled with the relatively low yield of patients presenting with acute bleeds, has resulted in slow adoption of the technology.
 
For over two years UK Medical have been working with NICE in conjunction with York Healthcare Economics Consortium in order to present evidence on clinical effectiveness and uncover the true costs of patient care in relation to management of acute oesophageal bleeds, linked to chronic liver disease.
 
With NICE guidance in place and access to the summarised clinical data, along with new cost modelling bringing transparency to previously hard to quantify hidden costs, adopting Danis as your first line option for treatment of acute Oesophageal bleeds has never been easier.
 
Danis stent supported by NICE

Danis is the ‘one size fit’s all’ stent that facilitates rapid unguided deployment, to quickly tamponade the bleeding vessel and reliably achieve variceal haemostasis.

  • Pre-loaded stent provides ‘out of the box’ deployment
  • Easy step by step deployment guide
  • Designed to be placed without image or visual guidance
  • Gastric balloon facilitates accurate placement at the GOJ ‘every time’
  • Provides a bridge to definitive treatment for the underlying condition
  • Significant improves patient QOL 
  • Reduction in overall SAE’s compared to balloon tamponade
  • Reduced stay in ICU/HDU
  • Improved palliation for compassionate end of life care
Danis stent NICE guidance
Danis stent NICE guidance - 1

It’s about cost saving

“Studies show that Danis stent is better than the balloon tamponade device (a balloon inflation device that compresses the bleeding veins) in controlling bleeding in the short term. It can stay in place for up to 7 days. This is longer than the balloon tamponade, which needs to be removed after 24 hours. This allows more time to stabilise the person before their next treatment and also means that they do not usually need to stay in intensive care. Cost analysis concludes that Danis stent is cost saving compared with balloon tamponade because it reduces the number of days a person needs to stay in intensive care”
NICE MTG57 31st March 2021

The average saving in scenario 5a of the NICE MTEP appraisal relating to typical UK clinical practice is £2,424 per patient. Danis is expected to reduce the number of days a patient spends in ITU by 2.4 days, representing a huge cost saving, whilst also improving patient outcomes.

“The committee noted that the estimated difference in length of ICU stay had the greatest effect on the direction of the cost case results. Clinical experts estimated that length of ICU stay for the Danis stent group is 3.6 days, and 6 days for the balloon tamponade group. The EAC did a threshold analysis for this parameter and reported that Danis stent would be cost neutral or cost saving when the balloon tamponade group had an increased length of ICU stay of 0.6 days or more compared with the Danis stent group.”
NICE MTG57 31st March 2021

Danis stent NICE costs

More about the Danis Stent

The Ella Danis stent provides a fast, safe and effective treatment option for patients with refractory oesophageal variceal bleeds.

Designed to tamponade oesophageal varices whilst maintaining normal dietary intake and minimising the need for high – dependency observation, Danis can stabilise your patient allowing time to plan future treatment options and improve patient outcomes.

Benefits of the Danis Stent

  • Improved patient quality of life compared to balloon tamponade
  • A 2010 study concluded, ‘insertion of the SX-Ella Danis stent in patients with refractory variceal bleeding or complications of previous therapy is effective for the control of bleeding’1
  • Reduces potential resource-drain on high dependency units
  • Can be placed without imaging guidance in emergency situations
  • Significantly reduced complications and SAEs when compared to balloon tamponade in acute oesophageal varices1
  1. Escorsell A, et al., ‘Esophageal Balloon Tamponade Versus Esophageal Stent in Controlling Acute Refractory Variceal Bleeding: A Multicenter Randomized Controlled Trial’ (2016) Hepatology, (Vol 63, No.6)

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