International Journal of Technology Assessment in Health Care

General Essays

Systems to support health technology assessment (HTA) in Member States of the European Union with limited institutionalization of HTA

Montse Moharraa1, Mireia Espallarguesa1, Nadine Kubescha1, Maria-Dolors Estradaa1, Antoni Paradaa1, Hindrik Vondelinga2, Alessandra Lo Scalzoa3, Stelios Cristofidesa4, Eva Turka5 and Martin Raaba6

on behalf of Work Package 8 of the European network for Health Technology Assessment (EUnetHTA) project

a1 Catalan Agency for Health Technology Assessment and Research

a2 University of Southern Denmark

a3 Agenzia Nazionale per i Servizi Sanitari Regionali

a4 Ministry of Health of Cyprus

a5 Institute of Public Health of the Republic of Slovenia

a6 Swiss Tropical Institute and Swiss Network for Health Technology Assessment


Objectives: The aim of this study was to support health technology assessment (HTA) capacity building in Member States of the European Union with limited experience or without institutionalized HTA. The main output is a Handbook on HTA Capacity Building.

Methods: The methods used were worldwide surveys of (i) HTA organizations, (ii) information management units, and (iii) HTA educational programs. The results of two surveys (i & ii) were combined with expert opinion to produce the Handbook on HTA Capacity Building.

Results: Survey of HTA organizations (n = 41, response rate 35 percent). Most of the organizations were established by the government (61 percent), and all were not-for-profit. Working on HTA (80.5 percent) and doing research (63.4 percent) were the main lines of activity. Survey on information management units (n = 23, response rate 23 percent). Most (74.2 percent) of the responding HTA agencies reported having personnel dedicated to HTA information services. Survey on HTA educational programs (n = 48, response rate 60 percent). In total, nine Master of Science (MSc) programs were identified (three MSc in HTA and six MSc in HTA-related areas). Handbook on HTA Capacity Building. A group of twenty experts from thirteen countries developed the handbook. It consists of nine chapters focusing on HTA institutional development (structural setup, work processes, and visibility).

Conclusions: Setting up organizational structures and establishing effective HTA programs that guide key policy decisions is a challenging task. There are no standard models or pathways. “One size fits all” is not a useful principle because of the wide systemic and cultural differences between countries. The Handbook on HTA Capacity Building includes approaches for overall institutional development, especially in formulating objectives, setting up structures, and defining work processes.


The authors thank the Partners in the EUnetHTA Work Package 8 (WP8) and colleagues of partner institutions that contributed to the work. Acknowledgements can be found elsewhere (7). This study was undertaken within the framework of the European network for Health Technology Assessment (EUnetHTA) Project, which was supported by a grant from the European Commission (Grant agreement 2005110 project 790621). The sole responsibility for the content of this publication lies with the authors, and the European Commission is not responsible for any use that may be made of the information contained therein.