History and structure
In 2001 the Health Research and Development Council and the Council for Medical and Health Research from the Netherlands Organization for Scientific Research have integrated to form a new organization: the Netherlands Organization for Health Research and Development ZonMw. One of the main programs of ZonMw is a research program on the efficiency of health care, the Health Care Efficiency Research Program. This program is financed by the Ministry of Health, Welfare and Sports (Dutch acronym VWS).

Mission
ZonMw is a national organization that promotes quality and innovation in the field of health research and health care, initiating and fostering new developments. In the same line ZonMw actively promotes knowledge transfer and implementation. This means that knowledge is exchanged between all relevant stakeholders (for example health researchers, health professionals, patients/consumers and the general public), not only for transfer, but also for structured implementation of newly developed knowledge into the health care system and of emerging health care questions into the research agenda.

In short, one of the basic challenges of ZonMw is to enable mutual exchange of innovation and inspiration between the various stakeholders of the same 'knowledge continuum': from basic, strategic and applied research to daily health care services. ZonMw fulfils the role of intermediary organization between policy, research and practice. Evidence-based medicine, relevance-based science, information-based policy: it is ZonMw's firm believe that only through an active exchange of ideas, knowledge and experience the innovation cycle is able to flourish and to contribute to an up-to-date society.

The main assigning bodies of ZonMw are the Ministry of Health, Welfare and Sports (VWS) and the Netherlands Organization for Scientific Research (Dutch acronym NWO). VWS, as governmental department, holds its main perspective in the contribution to public health including prevention and health services. NWO is the non-governmental organization in the area of fundamental and strategic research and plays - as the national research council - a key role in the development of science, technology and culture in the Netherlands. With respect to health research and development - and thereby its mandate to ZonMw - NWO holds its main interest in the contribution to cure, care and prevention through a better understanding of the (molecular basis and epidemiology of) disease and research related to medical or health technology assessment.

How ZonMw works
One of the main programs of ZonMw is the Health Care Efficiency Research Program. The program consists of three separate sub-programs: Innovation, Effects & Costs and Implementation.
The aim of the subprogram Innovation is to stimulate research on the (cost-)effectiveness of innovations in health care and on organizational developments. It has to be motivated that the innovations and developments are expected to contribute to efficiency in health care.

The center piece of the program is the subprogram Effects & costs. At regular intervals priorities for this subprogram are set. In the period 2001-2004, the priorities included PET-scanning, infertility problems and HTA-methodology. In more recent years the Ministry of Health asked ZonMw to investigate priorities for research by questioning all relevant stakeholders: professionals and patients and their organizations, health care providers and insurers and the organizations involved in benefit package decisions. This resulted in 8 priority themes for the subprogram Effects & Costs for research starting in the period 2007-2009: hematology/oncology, minimal invasive technologies, pharmacotherapy, children, elderly, gynecology/obstetrics and organizational aspects (like disease management).

Besides the focus on priorities, an open bottom up process offers to a limited extent the opportunity for health care professionals and researcher to submit proposals on any topic. There is an annual cycle for submitting research proposals to ZonMw. In a peer review process the relevance and scientific quality of the proposals are evaluated by subcommittees. Decisions about funding are based on these advices.

The aim of the sub-program Implementation is to examine whether, and how, cost-effective interventions can be incorporated into health care practice. Another aim is to gather generally applicable knowledge on the process of innovation and implementation in health care, in order to promote the transfer of experience gained.

Recently the Health Care Efficiency Program was evaluated in an internal and external review procedure. It was recognized that the program has established firmly its position in the first 5 years. In 2007 the focus of the program was extended by research on pharmaceuticals for which the department of Health allocated additional budget.

Dissemination activities
Dissemination activities will include the publications of annual reports, TA-reports and research findings through various media, including newsletters, website and peer-reviewed literature. There is an active policy to achieve implementation of the results of the projects. The importance of implementation is recognized both on the level of the program as on the level of the separate projects. For instance, last year a knowledge synthesis was carried out on Fertility Problems (2005) and on PET-scanning in The Netherlands (2007). The basis of this knowledge synthesis are 6-7 research projects on these topics, funded by ZonMw.

Current projects
There are 225 research projects funded (2007) and about 100 proposals under review. 

Future plans
Decisions on the proposals under review are expected June 2007.
To set new priorities for the period 2010-2012 currently a survey is carried out with all relevant stakeholders. In addition, discussion meetings, focus groups and invitational conferences are organized.