OBJECTIVES: Swiss Health Technology Assessment (HTA) initiatives have been fragmented, and official HTA processes by the Federal Office of Public Health (Bundesamt fuer Gesundheit, BAG) have been limited to new technologies and impaired by the absence of a clear-cut separation of assessment and appraisal. METHODS: Therefore, santésuisse (the national association of sick funds) and Interpharma (representing the interests of the Swiss research-based pharmaceutical industry) initiated “SwissHTA”, a transparent and inclusive project designed to develop a national consensus how Switzerland might better use HTAs.  The process was led by a project team, with membership from santésuisse (and Helsana), Interpharma (and Roche), the Swiss federal government (BAG), the Swiss Medical Association (FMH), and the Swiss Academy of Medical Sciences (SAMW).  After seven retreats of the project team and three workshops in the course of 12 months, the team reached a consensus. RESULTS: The Swiss HTA consensus statement emphasizes the need for a broad technology focus (covering both new and existing ones by specific approaches following a common set of core principles) and recommends opportunities for stakeholder involvement throughout the HTA processes.  Primary evaluation criteria should be determined by the social preferences of the Swiss population, constrained by a prior normative commitment in line with constitutional provisions and the principled, rights-based legal tradition of Switzerland.  The full range of health-related benefits should be evaluated, and assessment of clinical evidence should take into account the level of evidence that can reasonably be expected in a given context, rating the degree of confidence in outcomes in relation to the relevance and the magnitude of the effects observed.  Economic viability should be evaluated based on budgetary impact and cost benefit ratios, whereas the consensus rejects the idea of uniform cost per QALY benchmarks. CONCLUSIONS: The Swiss HTA consensus combines a pragmatic approach with well-defined evolutionary options.