[Second-generation DES : New, but also cost-effective?]
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Updated: Jun 2, 2026

Sequencing of mRNA from Whole Blood using Nanopore Sequencing
Published on: June 3, 2019
F Müller-Riemenschneider1, T Reinhold, S N Willich
1Institut für Sozialmedizin, Epidemiologie und Gesundheitsökonomie, Charité - Universitätsmedizin Berlin, Deutschland. falk.mueller-riemenschneider@charite.de
Background:
The objective of the present review was to investigate the cost-effectiveness of second-generation drug-eluting stents (DES) compared to bare metal stents (BMS) as well as to first-generation DES.
Methods:
A structured literature review in MEDLINE was conducted to identify all studies investigating the cost-effectiveness of second-generation DES published up to December 2010. Pre-specified selection criteria were applied to identify relevant studies. Standardized data extraction was performed to summarize clinical, economic, and cost-effectiveness outcomes of these studies.
Results:
Of only five studies which met all selection criteria from the US, UK, and Spain, three investigated the cost-effectiveness of the zotarolimus-coated Endeavor stent (ZES) compared to BMS, and two studies the ZES with first-generation DES.
Conclusion:
In summary, there is currently a lack of evidence with regard to the cost-effectiveness of second-generation DES, especially in Germany. However, studies from other countries provide some evidence that second-generation DES appear to generally not be cost-effective compared to BMS. Also, there is no conclusive evidence of cost-effectiveness compared to first-generation DES. Moreover, there are currently no studies investigating the cost-effectiveness of the Everolimus-coated Xience V stent. Methodologically rigorous economic evaluations addressing these issues within the context of the German health care system are therefore urgently required.
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