For patients, innovations in healthcare can be both a great blessing (when saving people's life or improving quality of life), as well as a curse (when only few people have access, e.g., because of high prices). Thus, when healthcare innovations are proven safe and ready for application, decision makers have to apply access policies and sometimes face difficult assessments. In this context, health technology assessment (HTA) plays a crucial role at European Union level, forming an evidence-based, transparent basis for decision making through joint assessments. However, pricing and reimbursement aspects are exempt from collaborative assessments, since these are in the responsibility of the EU Member States: according to Art. 168(7) TFEU the 'organisation and delivery of health services and medical care [… including] the allocation of the resources assigned to them' remain an exclusive competence of Member States. However, future challenges may require further cooperation.