OBJECTIVE: To evaluate the opportunity of introducing new technologies in the medical device formulary of the Azienda Ospedaliera di Verona. As an example, kyphoplasty evaluation is described. METHODS: In order to control the medical devices purchasing process, at the Azienda Ospedaliera di Verona (two hospitals, one teaching and one general, accounting for about 2000 beds) a multidisciplinary Medical Devices Formulary Committee (MDFC) was established. The tasks of the MDFC are: to evaluate the introduction of new medical devices in the hospital formulary; to monitor the appropriate use of medical devices after their introduction. The committee approves the introduction into the formulary of new medical devices with innovative features, based on documented efficacy and a favourable cost/benefit ratio. For kyphoplasty, efficacy data were collected from published literature. Cost information were computed taking into account: the cost of the device, the personnel, the operating room, length of stay, from the hospital perspective. RESULTS: At the time of the evaluation, published evidence describing the efficacy of kyphoplasty consisted mostly of uncontrolled retrospective studies. Regarding cost, the overall cost of the procedure was calculated as follows: device Euro2.250, medical and nursing staff 486 Euros, health materials and operating room 185 Euro, length of stay 2.600 Euro, for a total of 5.521 Euro. The DRG reimbursement associated with the use of kyphoplasty with no complications is Euro4.200, which does not cover the overall cost of the procedure. CONCLUSIONS: Despite poor clinical data and unfavourable economic analysis, the MDFC approved the use of kyphoplasty only for 10 selected patients per year, requiring the physician to report the outcomes of the treated patients, in order to re-evaluate the use in the future.