Health technology assessment in Luxembourg

Luxembourg's public health insurance is a compulsory insurance for all empl oyees, self-employed professionals, farmers, and pensioners. It is financed through contributions of the insured people, as well as by state taxes. Pr oviders of health care are mainly private nonprofit institutions and self-e mployed professionals. All healthcare procedures are defined in fee schedul es determined by a common decision of the Ministers of Social Security and Health according to proposals of a board of experts. The relative value of a service is also determined by the corresponding fee schedule. Hospitals a re financed by individual budgets negotiated between each hospital and the health insurance. These hospital budgets do not cover services provided in hospitals by medical specialists, who are reimbursed on a fee-for-service b asis. A law on hospital planning and organization allows the government to restrict the installation in hospitals of very expensive equipment or of eq uipment for which there is only a limited need in Luxembourg hospitals. Unt il recently there has been limited interest in or use of health technology assessment (HTA). However, large hospital investments have provoked some in terest in the last few years. The Ministry of Health has asked for some HTA studies when a concrete decision had to be taken. Luxembourg decision make rs have become more aware that HTA may help them to become more informed ab out the short- and long-term consequences of the application of health tech nology.