OBJECTIVES Veneto leads the nation in terms of better health status and pharmaceutical expenditures within budget. This study aimed to assess the region’s Health Technology Assessment (HTA) approach (structure, methods, and process of conducting HTA) by observing Evaluation of Pharmaceutical Effectiveness Unit’s (UVEF) evaluations on drugs, the concomitant Regional Technical Commission (CTR) decisions on formulary inclusion, and the evidences considered. METHODS We reviewed all HTA reports in the UVEF website evaluating the HTA dimensions assessed, if they were in line with the HTA scoping document by the Regional Decrees (2008), and changes over time. Further, this research evaluated the presence of explicit explanations behind each CTR decision. RESULTS