Diffusion and use of health technology assessment in policy making: What lessons for decentralised healthcare systems?

The Italian National Healthcare System (NHS) is one of the most decentralised systems since the devolution reform approved in 2001. HTA is spreading as an important tool for decision-making processes both at central and local levels. The aims of this study were to review the state of the health technology assessment (HTA) programmes in Italy – with a focus on regional and central initiatives – and to discuss consequences of a multi-level structure of HTA agencies in highly regionalised healthcare systems.