Health policy goals in Lithuania until 2020 include increasing transparency, cost-effectiveness and a rational use of resources as well as ensuring evidence-based care and access to safe services of high quality. Despite repeated initiatives, a systematic application of HTA is so far not in place in Lithuania. Individual HTA activities have begun to take root, most prominently in the field of medical devices at the State Health Care Accreditation Agency under the Ministry of Health (SHAA). For the SHAA we formulated a HTA-Strategy for Lithuania (http://eprints.hta.lbg.ac.at/1064) in the context of a EU funded project. Together with local partners we undertook a background analysis of the Lithuanian healthcare system, for which we locally conducted 19 expert interviews with stakeholders. In addition, a systematic search of the literature to identify HTA strategy papers was conducted, complemented by hand searches. The recommendations developed (and activities proposed) for Lithuania based on this report are published in a separate document, the HTA-Strategy for Lithuania (http://eprints.hta.lbg.ac.at/1064). 
 More generally it was found that the regulatory environment is essential for the role of HTA. HTA's impact is greatest, when conducted for supporting concrete decisions. Timely produced HTAs of good quality with clear messages are important, which offer valid and reliable decision support that is open to scrutiny. Not only HTA products themselves require transparency, also the entire HTA process (from topic selection to implementation) demands it for ultimate acceptability of the method. HTA needs to be independent from health policy and from providers (professions, industry) in order to be respected, which also requires a stable funding-basis