History and structure
The National Agency for Regional Healthcare (Age.na.s.) is a public agency founded in 1993. In the Italian healthcare service the Agency plays as a technical body supporting  the Ministry of Labour, Health and Social Services (MoH) and Regions. The Agency also coordinates health research programs financed by the Ministry of Labour, Health and Social Services or by the Regions.  
The State-Regions Committee which comprises of representatives of Regions and makes joint policy decisions shared between regions and central government, defines the strategy of  Age.na.s.
The Agency’s objectives is to promote innovation and quality in health care and to perform comparative analysis of the cost and effectiveness of the services offered to the public.
The HTA activity started as a research activity, as partner in different national projects and in the EUnetHTA project. The Financial Act of 2007 has determined that the agency would support the Ministry in the evaluation of biomedical technologies. 

Mission
In the field of HTA, the Agency’s role is:

• Supporting the priority setting process (collecting regional and national views) both at national and regional level;
• Producing HTA reports for the MoH;
• Supporting HTA programmes’ development in the regions.

Aim
Our aim is to provide the instruments needed to allow the Italian Healthcare System to grow.  We achieve this by assessing innovations, new technologies, organizational and administrate tools that can be used to provide solutions to enhance the efficiency and quality of the healthcare system. We provide the instruments used for planning and carrying out checks and controls at different levels within the Healthcare system.

How Age.na.s. works
Age.na.s heads four national programmes:

• Health Technology Assessment (HTA);
• Clinical risk and patients’ safety;
• Clinical and organisational guidelines;
• Core benefits and health expenditure monitoring. 

To achieve these objectives we have four technical departments:

• Innovation Research and Development (IRD). Comprising of HTA and Horizon Scanning
• Healthcare quality and accreditation
• Healthcare organisation
• National framework for health services (core benefits and health expenditure).

Age.na.s employs epidemiologists, health economists, social scientists, bio-statisticians, clinical engineers, information specialists and administration support staff.

Knowledge transfer and dissemination
Transfer and dissemination is carried out via the Age.na.s. website, a periodical publication “Monitor”, articles in national and international scientific journals, meetings and seminars.

Current projects related to HTA (a selection)
Since 2007 we have produced three HTA reports:

• Wireless Capsule Endoscopy in the diagnosis of small bowel disease
• Prostheses for primary total hip replacement in Italy
• Rapid (bed-side) tests for influenza
  

HTA for 2009

• Diagnostic imaging for osteoporosis
• Knee prostheses

A full list of Age.na.s. ongoing and completed projects can be found at www.agenas.it

Future plans
At a national level the Agency is managing a process to establish formal relationships among different actors involved, setting up relations with health workers, with universities, with ISS (Istituto Superiore di Sanità – National Institute for Health) with scientific societies, with industries and Regions. We are looking at a more advanced legal framework to improve HTA coordination and a wide process of dissemination.
During 2008 Age.na.s. also started two important research projects finalized to organize a national system of horizon scanning and to organize a knowledge exchange platform for HTA.   
At the international level Age.na.s. is founding partner of EUnetHTA Collaboration and will support the future European Joint Action on HTA network.