In Europe, the medical equipment sector is characterised by a large share of overall health budgets spent for the provision of healthcare services through the use of capital investment goods such as medical scanners, radiotherapy units, etc. At the same time a high variability in provision and utilization rates of medical equipment can be observed between Member States. This high variability may suggest the need for improving efficiency in the use of medical equipment. Hence, one way of addressing potential efficiency gains may be found by pooling resources between Member States. Further, policy trade-offs between efficiency gains are likely from the perspective of public payers and the patients (i.e. travelling distance and related costs). This study is related to various policy initiatives initiated by the European Commission: The Patients' rights in Cross-border Healthcare Directive, more specifically in the areas of Cross-border cooperation (Article 10, paragraph 3), Article 8 Healthcare that may be subject to prior authorisation and Cooperation on HTA (Article 15). The Commission Communication on effective, accessible and resilient health systems ; Interregional cooperation programmes Moreover, this study supports the follow-up to the December 2013 Council Conclusions on the "Reflection process on modern, responsive and sustainable health systems". In particular, the invitation to the Commission to "support exchanges of best practices and mutual learning among Member States on the effective and broader use of European Structural and Investment Funds for health investments.