OBJECTIVES: To assess the degree to which methods and recommendations converge in health technology assessments of drug eluting stents after the 2006 alert on DES safety. METHODS:  A detailed comparative analysis of HTAs of DES, conducted by the National Institute for Health and Clinical Excellence, Ludwig Boltzmann Institute, Kenniscentrum voor de Gezondheidszorg and the Programs for Assessment of Technology in Health was assessed to investigate the findings and the convergence or divergence in evidence considered, methods of assessment and recommendations.  RESULTS: The clinical evidence was obtained from randomised controlled trials (RCTs), non-RCTs, meta-analyses and registry data for the assessments. A total of 33 RCTs were identified in all assessments of which thirteen appeared across more than one assessment and seven were found across all assessments. The common endpoints included mortality, myocardial infarction, target lesion revascularisation (TLR), target vessel revascularisation (TVR) and stent thrombosis. The trial data showed no overall risk of stent thrombosis in DES except for one agency that considered the BASKET late trial. Registry data was used by three of the agencies, which identified 35 studies. Of these studies, six were included across more than one assessment and one in all assessments. All analyses found that DES statistically improved the rates of TLR and TVR. The registry data for each country were used to populate the economic models and data from meta-analyses were used to adjust the relative risk reduction of using DES in patients requiring repeat procedures. The agencies considered a variety of patient groups. These differences may explain some of the variation in cost effectiveness results. CONCLUSIONS: The processes and methods used were broadly similar across the agencies. However, the information used for the economic models was based on country specific registry data. The different data sources may explain some of the variation in reimbursement decisions.