An overall theme of the paper is that there are a number of determinants of the effectiveness of an HTA program, only some of which are within the control of those who operate the HTA function. [...] The diversity of organizations and governance arrangements within the membership of the INAHTA agencies provides an example.3 The governance entity will often determine and monitor the mandate of the HTA program and suggest directions at a high level - such as whether there is to be a focus on assessment of particular types of technology. [...] Advantages of external contracting include the possibility of using leading experts in a field and of avoiding the demands of maintaining a group of assessors. [...] Determinants of effectiveness - resources Collaborative and contractual Resources Staff and structure relationships of HTA program Governance and Provision mandate of the Advisory Evaluation of advice HTA program committee(s) (HTA products) and dissemination ELEMENTS OF EFFECTIVENESS FOR HEALTH TECHNOLOGY ASSESSMENT PROGRAMS 7 Staff within an HTA program and those with whom they collaborate will h [...] Identifying the relative importance of these, the levels of response that would be appropriate and then managing the conflicting Scheme 6 demands of clients with the resources available are major issues in the Determinants of effectiveness - management of an HTA program.