The situation of health technology assessment in Hungary Ministry of Health, Budapest, Hungary; After Hungary's accession to the European Union (1 May 2004) technology assessment plays a mandatory role in granting social insurance subsidies.In every case the process starts with licensing/registration, then continues with decisions on social insurance inclusion, and if judged so after a period of time, it ends with exclusion from circulation/subsidy. In all this cost-efficiency, health policy, social-political and insurance policy considerations also play a role. This is the process in which the National Institute for Strategic Health Research (ESKI) takes part as it supports decision-making by preparing background materials, analyses and studies. Within this the Technology Assessment Office (TEI) supports decision-makers of the committee of the National Health Insurance Fund (OEP) that awards social insurance subsidies with its work of evaluating pharmaceutical subsidy applications. The basic criteria of this work among others are cost-efficiency and ranking/qualifying of the technology to be replaced or the problem to be solved. The inclusion of pharmaceutical products operates in accordance with the principle of transparency: Within the framework laid down by law the appropriate data sheet with its supplements are passed to the Pharmaceutical Division of the National Health Insurance Fund (OEP), where in a simplified case the inclusion of generic drugs, as well as new potencies and packaging, etc. takes place directly on the premises. The documentation of drugs containing new agents are transferred to ESKI TEI, where evaluation of applications are prepared for the OEP committee that makes recommendation for inclusions. After the committee decisions all final recommendations are made in OEP's Pharmaceutical Division that are then disseminated as law by the minister of health in agreement with the minister of finance. There is a possibility for appeal. In that case the director of OEP makes decisions.