Health technology assessment in Poland, the Czech Republic, Hungary, Romania and Bulgaria

  • László GulácsiEmail author
  • Alexandru M. Rotar
  • Maciej Niewada
  • Olga Löblová
  • Fanni Rencz
  • Guenka Petrova
  • Imre Boncz
  • Niek S. Klazinga
Original Paper


This paper describes and discusses the development and use of health technology assessment (HTA) in five Central and Eastern European countries (CEE): Poland, the Czech Republic, Hungary, Romania and Bulgaria. It provides a general snapshot of HTA policies in the selected CEE countries to date by focusing on country case-studies based on document analysis and expert opinion. It offers an overview of similarities and differences between the individual CEE countries and discusses in detail the role of HTA by assessing its formalization and institutionalization, standardization of methodology, the use of HTA in practice and the degree of professionalization of HTA in the region. It finds that HTA has been to some extent implemented in all five countries studied, with methodologies in accordance with international standards, but that challenges remain when it comes to the role of HTA in health care decision-making as well as to human resource capacities of the countries. This paper suggests that coming years will show whether CEE countries develop adequate national analytical capacity to assess and appraise technologies in the context of local need and affordability, instead of using HTA as a mere administrative procedure to fulfill (inter)national requirements. Finally, suggestions are provided to strengthen HTA in CEE countries through cooperation, mutual learning, a common accreditation of HTA bodies and increased network building among CEE HTA experts.


Health technology assessment Bulgaria Czech Republic  Hungary Poland Romania 

JEL Classification

I 180 



The authors would like to thank Prof. Tomasz Pasierski, Head of the Cardiology and Cardiovascular Diseases Unit at the Specialist Hospital in Miedzylesie, Department of Bioethics in the Medical University of Warsaw and Head of the Transparency Board of AHTAPol for his invaluable comments on drug safety perception in reimbursement decision-making in Poland and to Dr. József Gajdácsi, Deputy Director General, Dr. Péter Varga, Head of Analysis, Medical Expertise and Controlling, National Health Insurance Fund Administration, Hungary and Gabriella Jóna, Head of TAHD, Hungary for their helpful comments and contribution.

Proofreading of the manuscript was supported by the TÁMOP 4.2.2./B-10/1-2010-0023 project.


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Copyright information

© Springer-Verlag Berlin Heidelberg 2014

Authors and Affiliations

  • László Gulácsi
    • 1
    Email author
  • Alexandru M. Rotar
    • 2
  • Maciej Niewada
    • 3
    • 4
  • Olga Löblová
    • 5
  • Fanni Rencz
    • 1
  • Guenka Petrova
    • 6
  • Imre Boncz
    • 7
  • Niek S. Klazinga
    • 2
  1. 1.Department of Health EconomicsCorvinus University of BudapestBudapestHungary
  2. 2.Department of Social MedicineUniversity of AmsterdamAmsterdamThe Netherlands
  3. 3.Department of Experimental and Clinical PharmacologyMedical University of WarsawWarsawPoland
  4. 4.HealthQuest Consulting CompanyWarsawPoland
  5. 5.Department of Public PolicyCentral European UniversityBudapestHungary
  6. 6.Department of Social Pharmacy and Pharmacoeconomics, Faculty of PharmacyMedical UniversitySofiaBulgaria
  7. 7.Institute for Health Insurance, Faculty of Health SciencesUniversity of PécsPecsHungary

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