OBJECTIVES: Several interviews with stakeholders have compared how Health Technology Assessment (HTA) activities, evidentiary requirements and approaches to dealing with uncertainty differ across countries. Nevertheless, no studies have elicited cross-country, HTA stakeholders’ preferences on criteria that shape coverage decisions. We aimed to identify the extent to which prioritization of criteria, uncertainties and other factors that inform HTA decision-making differs across countries. METHODS: HTA stakeholders in Brazil, England, France, Italy, Netherlands, Spain and Sweden were invited via email to complete a web-survey. A number of clinical, economic and other criteria (i.e. rarity/orphan status and stakeholder input, among others) considered in HTAs, along with factors related to clinical evidence uncertainties, unmet need and innovative nature of treatment were ranked in terms of their importance on a 7-point-Likert-scale. Responses were anonymised and analysed using descriptive statistics. RESULTS: Responses were received from Brazil(n=9), England(n=7), France(n=10), Italy(n=6), Netherlands(n=3), Spain(n=3) and Sweden(n=3). "Achievement of/Concerns around clinical benefit" was the only clinical criterion/uncertainty ranked as 6(=high) and/or 7(=very high) in importance by 100% of respondents in each country. The requirement for/uncertainty around "Appropriate comparators" was highly important overall but country preferences fluctuated; i.e. ranked above 6 by more than 80% of respondents in all counties apart from Spain and Sweden (50% and 33% respectively). "Budget impact analysis" was the most important economic criterion overall, although not consistently ranked across countries; i.e. ranked above 5 by 100% of respondents in all countries apart from Italy and France (78% and 57% respectively). More subtle diffrences were identified in the priorities of innovation, disease severity and stakeholder input towards HTA decision-making across countries. CONCLUSIONS: We demonstrated cross-country variation in HTA stakeholders’ preferences, especially for economic and other criteria related to innovation and unmet need, possibly underlying differences in HTA recommendations. Further investigations are required to map the patterns that differentiate coverage decisions across countries.