Health technology assessment in Catalonia: an overview of past and future perspectives.

OBJECTIVES The current and past situation of health technology assessment (HTA) in Catalonia is presented in this study. METHODS The approach used here is a historical review of facts and landmarks. RESULTS Spain has undergone radical change in many aspects, but the changes in healthcare provision have been major indeed. Catalonia has had the ability to benefit from these changes and has been able to build upon professionals' experience and expertise to development a consistent HTA network and continuous evaluation paradigm. The early involvement of the Catalan Agency for Health Technology Assessment (CAHTA) in several relevant HTA international initiatives and the relationship of CAHTA and Research with other HTA agencies in Spain is also stressed. CONCLUSIONS HTA is currently of common use in Catalonia for decision making at different levels. Now emphasis has to be put on the coming challenges that the HTA community will have to face in the coming years: uncontrolled demand, capacity scarcity, a rapidly evolving knowledge frontier, and insufficient input from the economic sphere into evaluations.