Burning Issues in Health Technology Assessment and Policy Making: What's Keeping Senior Health Technology Assessment Users and Producers up at Night?

A key working session, held as part of the Health Technology Assessment international (HTAi) Global Policy Forum meeting asks members to share "What's Keeping Me Up At Night." Members-senior thought leaders from health technology assessment (HTA) agencies, payer organizations, industry, and the HTAi Board-share without fear or favor the thorny issues related to HTA that are challenging them now or likely to do so in the near future. This article contains a reflection on the discussions at this session over the last 2 years and focuses on the recurrent and repeated themes: internal and external stakeholder involvement in HTA processes; globalization of HTA and the future of HTA (namely innovative technologies, tide of data and the "war for talent"). While the aim of these informal sessions is not to produce solutions, it reinforces the importance of developing a truly multi-stakeholder HTA community with working relationships built on mutual trust and long-standing engagement.