OBJECTIVES: Mechanisms for assessing health technologies (HT) have gone through major regulatory changes over the last five years in Spain. This study aims to determine the consensus level amongst decision makers and experts on the present and future of health technologies’ assessment. METHODS: This is the second part of a two-phase study. A sample of participants and experts in HT evaluation was invited to participate on a two-round Delphi consultation (phase 2) about the most relevant and controversial issues identified in phase I. The present situation as well as desirable (D) and feasible (P) feature scenarios were considered. Consensus was reached when given statements were scored 7.5 or higher by 75% or more of the participants. RESULTS: Decision makers (n=16) and experts (n=8) participated in the study (mean involvement length in HT assessment: 12.4 [SD: 7.7] years). Present: Consensus was reached on that 1) the absence of established mechanisms to set priorities and define needs (83.3%), and the scarce political support (79.2%) explain the little influence of current legislation on HT implementation; 2) safety and efficacy (79.2%) are always considered to decide the implementation of HT. Coincidence of opinions existed for the poor definition of decision makers’ roles and responsibilities (70.8%) and the deficient management of information between evaluation entities and decision makers (62.5%).  Future: 1) Importance of value dossier and impact budget estimates (D: 95.8%, P:12.5%) to support implementation; 2) efficiency and cost-effectiveness data will determine decisions (D: 91.7%; P: 12.5); 3) benefits for patients (D: 87.5%; P: 41.7%) and equity improvements (D:91.7%; P:16.7%) will be prioritised; 4) gains on patients’ satisfaction, preferences and health related quality of life (HRQL) will deserve special attention (D: 75%; P: 12.5%) CONCLUSIONS: An important gap exists between desirable (D) and feasible (P) future scenarios. Agreement upon implementation mechanisms is mandatory. Patient centred results become relevant.