Since 1995, when the NHI was officially available in Taiwan, how to effectively utilize NHI resources and to avoid unnecessary healthcare waste has been a cause of concern. With limited resources, the Department of Health and the Bureau of National Health Insurance back then had to satisfy Taiwanese people’s healthcare needs. Therefore, how to adequately select payable times, set the payment criteria, and utilize resources carefully poses stern challenges for managing the NHI sustainably.
       When the National Health Insurance (NHI) program began, coverage items were defined without formal HTA; decisions were made based solely on expert reviews of manufacturers' application materials. In 2000, the Bureau of National Health Insurance considered implementing an HTA system to ensure that NHI decisions were made objectively and in alignment with evidence-based medicine. This was the first time HTA began to gain attention in Taiwan.
       At the end of 2000, the NHIA authorized scholars to conduct the “Taiwan Health Technology Assessment Creation and Implementation Project.” In the coming year, multiple health authorities in Taiwan sent representatives to respective HTA institutions in British Columbia, Canada; they brought back a lot of valuable data, which served as the important reference blueprint for promoting HTA in Taiwan.
       The Health Technology Assessment Task Force was formed in August 2007 to evaluate new drugs as authorized by the Bureau of National Health Insurance. The completed evaluation report would serve as a reference while the Pharmaceutical Affairs Task Force under the Bureau of National Health Insurance deliberated on the coverage of a specific drug in its meeting. At the end of 2007, the Board of Directors approved the establishment "Health Technology Assessment " which was subsequently filed with the Department of Health. Health Technology Assessment Unit was officially established on April 1, 2008.
       Since its establishment, the HTA has been assisting with the assessment of new drugs for NHI coverage. Starting in 2011, the scope of assessment has been gradually extended to cover special devices, and the complete HTA report is posted online. From 2014, HTA has also been applied to the assessment of some special innovative healthcare services. In 2015 onwards, patients are encouraged to take part in and perform the HTA of health policies authorized by the competent health authority. Since 2020, assistance has been provided to the National Health Insurance Administration under the MoHW in planning horizon scanning (HS) and since 2022, in health technology reassessment (HTR).
       On May 18, 2023, to address the future demand for precise payment and coverage of innovative health technologies and new drugs and to boost the throughput, quality and talent development of the HTA implementer, the National Health Insurance Administration under the MoHW, CDE and the United Kingdom National Institute for Health and Care Excellence (NICE) jointly signed the HTA collaboration agreement to gradually embark on applicable exchange activities and learn from the UK experience in the establishment of an authority to take charge of the National Health Technology Assessment Center.
       Since January 1, 2024, besides continuous reinforcement of the review of new health technologies, drugs, and special devices for coverage, pharmacoeconomics and policy assessments, talent development and promotion of international exchange and collaboration, HTA also provides support for parallel review and NHI coverage efficacy assessment following conditional listing of a drug for coverage in order to strengthen empirical scientific evidence and value-based NHI coverage policies, expedite the addition of drugs to coverage, properly utilize resources, reduce NHI and public burdens, and boost overall welfare at the same time.
       CDE HTA originally consisted of the division head and 2 task forces (1 efficacy assessment group and 1 economic assessment group). Later, as the scope of operation gradually expanded, it had the division head, vice division head and 5 task forces (2 efficacy assessment groups, 2 economic assessment groups and 1 project management group). The HTA has now grown into a professional team of over 60 members and continues to grow. Among them are about 15% PhDs, 75% masters and 10% bachelors’ of medicine, pharmacy, nursing, statistics, pharmacoeconomics, medical affairs management and public health, among others; they perform health technology and policy assessments, etc. 

       Health technology assessment (HTA) mainly consists of the following:
1.    Performing health technology assessment of NHI-covered medical services and drugs payment items and criteria.
Performing, reflective of the characteristics of respective cases, efficacy and economic review and assessment (including relative clinical efficacy, cost-effectiveness, and financial impact, etc.) of new drugs and new special devices recommended to be covered as proposed by the holder of the drug permit, collecting related empirical scientific evidence, or providing analytical reports of applicability in our country, which will be referred to during review in the Joint Preparation Meeting for National Health Insurance Pharmaceutical Benefit and Reimbursement Scheme.

2.    Evaluating, researching and advising on health policies.
Helping with governmental health policy discussion and assessment primarily for the purpose of evaluating the trends and dynamics of the respective policies that are being planned or already enforced and the efficacy of policies once implemented applying health technology assessment methodology and providing national health policy-makers with related empirical scientific evidence and advice to help with the preparation and planning of short-term, mid-term and long-term health policies.

3.    Developing and defining HTA methodology and guidelines.
HTA can be applied to drugs, medical devices, surgical dispositions, health policies, or healthcare systems, among others so that the value of health technologies at different time points throughout their life cycle may be evaluated combining defined methodology consisting of diversified disciplinary approaches. HTA aims to provide policy-makers with empirical bases while the latter define policies in order to promote a fair, effective and high-quality healthcare system. In other words, development and creation of assessment methods and guidelines are essential of HTA.

4.    Providing HTA-related consultation service. 
Providing stakeholders (drug permit holders) with HTA-related consultation services in order to help perfect submissions for review of NHI coverage as recommended and develop biotech medicine in Taiwan.

5.    Training the talent needed for and promoting HTA.
Continuing with the talent development task as the demand for professional HTA talent increases each day, in order to develop professional HTA talent and to boost the assessment throughput, including the HTA program design and development to offer advanced training and continuing education opportunities for professionals already working in the field of HTA and to help develop their professional knowledge and update their skills and provide academe-research collaboration opportunities through practical training, workshop and research projects where students acquire professional knowledge and skills and get hands-on opportunities for reinforcing their practical experience. In addition, to facilitate knowledge of HTA reports and applicable research findings, related external promotional activities are available.

6.    Advancing domestic and international exchange and collaboration in HTA.
The scope of domestic and international exchange and collaboration in HTA includes collaboration in the construction of a collaborative network, involvement in cross-national joint research projects, organizing or attending international conferences and seminars, and inviting international experts to visit Taiwan, etc..
(1)    Collaboration in the construction of a collaborative network: Partnerships with international HTA organizations, domestic and international governmental agencies, domestic and international academic institutions and industrial organizations are established to promote knowledge exchange and sharing; 
(2)    Involvement in cross-national joint research projects: new HTA methods, techniques and applications are explored and research findings are shared;
(3)    Organizing or attending international conferences and seminars in order to boost academic exchange and professional collaboration in the field of HTA;
(4)    inviting international experts to visit Taiwan in order to boost mutual learning and sharing of related knowledge and practical experiences.

7.    Other matters relevant to health technology and health policy assessments.