This session reviews the experiences, outcomes, and consequences of HTA agencies' evaluations of specialised, innovative technologies such as gene and cell therapies and new cancer drugs. The authors discuss how HTA agencies have evaluated manufacturers' submissions, in particular their critical appraisal of assumptions about long term benefits and claims about whether therapies offer a cure. Authors reflect on how predictions of the uptake of innovative technologies compare with real world uptake, and report large discrepancies which may indicate inaccuracy or uncertainty in evaluation methods, and/or highlight barriers to adoption. The cost-effectiveness of screening strategies for inherited risk factors are also discussed.