ISSUE:  The European cooperation on HTA through the work of EUnetHTA has delivered methodological and process support tools which facilitate joint scientific work and production of the HTA information that can be shared across borders. The HTA Network Strategy and recent Council Conclusions have also provided the political support to strengthen the EU cooperation. A few important questions still need to be answered in order to deliver a permanent solution for a sustainable mechanism of the HTA cooperation in Europe. How can the joint work and output produced at the European level fit into the national HTA – and decision-making processes? How to ensure that the European cooperation process contributes effectively and efficiently to the HTA processes in the participating countries? What are the obstacles, opportunities and concrete plans to address the issues of synergy between the European cooperation on HTA and national HTA and decision-making processes? Regional cooperation efforts between Member States are emerging, how can they be supported by EU cooperation? OVERVIEW: The methodological aspects of joint HTA work and scientific process support tools have been addressed and developed in the previous joint actions on HTA, the third Joint Action focuses on strengthening joint production and will also address organizational issues to make proposals for a permanent solution for EU cooperation. Decision-making on patient access to health technologies is and will remain a sole national competence of the EU Member States. The national HTA process informs and adheres to the organisation of the national decision-making processes. These can be similar but also differ substantially between the EU Member States, thus influencing how to cooperate on HTA across borders effectively and realise the full European added value of such cooperation. Perspectives, positions and experiences or plans for specific activities addressing this issue will be presented and discussed by a EUnetHTA Partner organisation, the European Commission and EU Member State healthcare decision-maker.