2. HTA bodies – organisational setup
Effective HTA bodies are able to ensure methodological rigour, and use multi-disciplinary inputs to produce and disseminate high-quality, policy-relevant recommendations to decision-makers within the healthcare system. This requires the HTA body to fit into the decision-making processes of the healthcare system and be adapted to the needs and the governing interests of decision-makers.
How HTA Bodies Are Structured
🏥 Regional HTA Bodies
These are commonly found in decentralised healthcare systems, where decision-making is distributed across regions or provinces.
Example: Spain, where provincial HTA bodies operate independently.
🏛️ Centralised HTA Bodies
Common in unified healthcare systems, where one main organisation manages national-level assessments and guidance.
Example: France, with a central HTA authority.
Types of HTA Organisations
Often in countries where the state funds healthcare
Financed through taxes or contributions
Funded through a combination of public and private sources
HTA services for by private companies
Conduct HTA for governments or private organisations
Initiated and funded by universities or research institutions
Number of HTA Bodies per System
- Centralised systems: Usually have one main national HTA body (e.g., NICE in the UK).
- Decentralised systems: Host multiple HTA organisations at national, regional, or provincial levels (e.g., Italy, Spain).
- 15 countries have a single national HTA body.
- 12 countries have multiple national HTA organisations.
The following table, adapted from the EC 2018 study, provides an overview of the organisational setup and scope of HTA bodies in the EU and Norway.
| One national HTA body | Two or more national HTA bodies | ||||||
|---|---|---|---|---|---|---|---|
| One national HTA body, having only one main role - HTA recommendations | One national HTA body with regulatory functions | One national HTA body, with P(&/or) R functions | One national HTA body regulatory +P(&/or) R functions | Two or more national HTA bodies, at least one with regulatory functions | Two or more national HTA bodies, at least one with P(&/or)R functions | Two or more national HTA bodies, combining regulatory and P(&/or) R functions | |
| Countries |
Bulgaria Denmark France Poland Slovakia UK |
Finland Hungary |
Latvia Luxemburg Malta Netherlands |
Cyprus Czech Republic Portugal |
Spain |
Austria Belgium Croatia Germany Ireland Sweden |
Estonia Italy Lithuania Romania Slovenia Norway |
| Total number | 6 MS | 2 MS | 4 MS | 3 MS | 1 MS | 6 MS | 5 MS + Norway |
Table 1. HTA system organisation in EU and Norway