OBJECTIVES: To select medical technologies that should be provided to the general public under the National Health Law. The rapid development of new technologies and the limited budget of the health care system make the selection process difficult. The research focused on the Israeli National Health Care System that faces budgetary constraint. Once a year a fixed budget has to be allocated among a set of candidate technologies. The constraint imposed by the fixed budget must be taken into account in the decision-making process. METHODS: We developed a Group Decision Support System based on a three- dimensional model: 1) Benefit (measured by the effectiveness of each technology); 2) Risk (measured by EBM); and 3) Cost: Based on the Analytical Hierarchy Process (AHP) methodology, a set of criteria was developed by a group of medical experts, economists, patient representatives, sociologists, law experts and ethical experts. EBM was used to assess the Risk (knowledge gap) associated with each alternative. While Cost was estimated by explicit market price of the technology in consideration. RESULTS: A set of candidate medical technologies evaluated by the proposed methodology revealed a clear Pareto distribution. The proposed methodology helped the decision-makers focus on the most promising technologies out of a total 193 technologies proposed. CONCLUSIONS: The proposed methodology helped decision makers by focusing their attention on the most promising medical technologies based on predefined objective set of criteria. The decision process is more effective and it achieves higher efficiency by using the Group Decision Support System (GDSS)