Operationalized criteria of efficacy, suitability and cost-effectiveness are the point of departure and at the same time serve as the crucial target criterion for an assessment of elements in the range of services covered by the compulsory health insurance. For the systematic evaluation of medical interventions, the system of Health Technology Assessments (HTAs) is a recognized instrument of scientifically based political support that has largely established itself internationally based on the Office of Technology Assessment of the US American Congress (OTA, as from 1975).

HTAs that differ in the details of their form and function have since been used in numerous countries to evaluate the medical, social, economic and ethical implications of medical procedures and products in a way that is systematic, transparent and robust. The anticipated effects include in particular an improvement in quality and an increase in the cost-effectiveness of medical care. Possible instruments used for this are the recommendation of effective and economical services and conversely also the exclusion of services that offer no adequate evidence of benefit and / or no cost-effectiveness, as well as the development of binding guidelines on use.

Different definitions were proposed for HTAs, whose common features consist primarily in the multidisciplinary approach and in the systematic evaluation of the benefit of interventions, whereas the consideration of costs and cost/benefit relations differs considerably in some cases.

For a successful implementation of HTA results, a direct association of HTAs with defined political decision-making processes is crucial. At the same time, factors of major importance are the reputation (credibility and independence) of the institution(s) responsible for HTAs, the transparency of processes and criteria and the integration of stakeholders, as well as the quality and timely availability of HTA reports.