Coverage and reimbursement decisions are made centrally. Poland is also one of the few countries to compare the cost-effectiveness of alternative technologies, to periodically reassess technologies in the benefit package, and to publish the incremental cost-effectiveness ratio used to inform coverage decisions (the current threshold is set at three times the Polish GDP per capita). Patient representatives are induded in HTA decisions through the Polish Ombudsman for Patients' Rights (Auraaen et aL, 2016).