Policy issues• Health technology assessment (HTA) is an important tool for informing effective regulation of the diffusion and use of health technologies.• The key policy issues surrounding the use of HTA fall into three areas: (a) the bodies, decision-makers and other stakeholders involved, (b) the methods and processes employed; and (c) how the findings of HTAs are implemented.• The impact of HTA can be enhanced if: key stakeholders (e.g. patients, providers and industry) are adequately involved; decision-makers give a prior commitment to use assessment reports (and assessments meet their needs); the necessary resources are available for implementing decisions; there is transparency in the assessment and decision-making processes; and collaboration, knowledge and skills are transferred across jurisdictions.Policy measures• Increased stakeholder involvement throughout the HTA process can help capture and improve the real-world value and applicability of HTAs. Nevertheless, stakeholder involvement needs to be transparent and well-managed in order to ensure that the objectivity of assessments is not influenced.• HTAs must be timely in relation to the decisions they seek to inform. Simpler studies, early-warning systems and conditional approvals are increasingly being used to manage the uncertainty surrounding new and emerging technologies while facilitating the timeliness and relevancy of HTA.• International collaboration among HTA bodies can facilitate the development of methods and more efficient assessment processes, and facilitate knowledge transfer and capacity-building in less established HTA systems and programmes.• To facilitate the use and implementation of HTA reports in decision-making, incentives within a given health care system must be appropriately aligned with the decisions that are based on (or informed by) HTA.Implementation considerations• Problems with applying technical information and national recommendations to local decision-making can be reduced if there are formal links between the producers and users of HTA.• Learning through collaboration and exchange of experience can help to overcome those institutional and capacity barriers that often hinder implementation.