Does the approach to economic evaluation in health care depend on culture, values, and institutional context?

There is a fairly strong case to argue that culture, values, and institutional context have an influence on the use of HTA and economic evaluation in health care, either directly, or indirectly through the impact on the organization of the health care system. Therefore, this observation may be useful both in explaining the different approaches to the use of economic evaluation between countries and in determining the most appropriate use of economic evaluation for other countries yet to adopt the approach.