Skip to main content Accessibility help


  • Wija Oortwijn (a1), Pieter Broos (a2), Hindrik Vondeling (a3), David Banta (a1) and Lora Todorova (a4)...


Objectives: The aim of this study was to develop and apply an instrument to map the level of health technology assessment (HTA) development at country level in selected countries. We examined middle-income countries (Argentina, Brazil, India, Indonesia, Malaysia, Mexico, and Russia) and countries well-known for their comprehensive HTA programs (Australia, Canada, and United Kingdom).

Methods: A review of relevant key documents regarding the HTA process was performed to develop the instrument which was then reviewed by selected HTAi members and revised. We identified and collected relevant information to map the level of HTA in the selected countries. This was supplemented by information from a structured survey among HTA experts in the selected countries (response rate: 65/385).

Results: Mapping of HTA in a country can be done by focusing on the level of institutionalization and the HTA process (identification, priority setting, assessment, appraisal, reporting, dissemination, and implementation in policy and practice). Although HTA is most advanced in industrialized countries, there is a growing community in middle-income countries that uses HTA. For example, Brazil is rapidly developing effective HTA programs. India and Russia are at the very beginning of introducing HTA. The other middle-income countries show intermediate levels of HTA development compared with the reference countries.

Conclusions: This study presents a set of indicators for documenting the current level and trends in HTA at country level. The findings can be used as a baseline measurement for future monitoring and evaluation. This will allow a variety of stakeholders to assess the development of HTA in their country, help inform strategies, and justify expenditure for HTA.



Hide All
1.Wilsdon, T, Serota, A. A comparative analysis of the role and impact of health technology assessment. London: Charles River Associates. 2011.
2.Børlum Kristensen, F, Palmhoj Nielsen, C, et al.“What is health technology assessment?” in health technology assessment and health policy-making in Europe. Geneva: World Health Organization on behalf of the European Observatory on Health Systems and Policies; 2008.
3.Busse, R, Orvain, J, Velasco, M, et al.Best practice in undertaking and reporting health technology assessments. Working group 4 report. Int J Technol Assess Health Care. 2002;18:361422.
4.Lampe, K, Makela, M, Velasco Garrido, M, et al.The HTA core model: A novel method for producing and reporting health technology assessments. Int J Technol Assess Health Care. 2009;25 (Suppl 2):920.
5.Catalan Agency for Health Technology Assessment and Research. EUnetHTA Work Package 8. EUnetHTA Handbook on Health Technology Assessment Capacity Building. Catalan Health Service. Barcelona: Department of Health Autonomous Government of Catalonia; 2008.
6.Murphy, K, Packer, C, Stevens, A, et al.Effective early warning systems for new and emerging health technologies: Developing an evaluation framework and an assessment of current systems. Int J Technol Assess Health Care. 2007;23:324330.
7.Hailey, D. Toward transparency in health technology assessment. A checklist for HTA reports. Int J Technol Assess Health Care. 2003;19:17.
8.Drummond, M, Schwartz, J, Jonsson, B, et al.Key principles for the improved conduct of health technology assessments for resource allocation decisions. Int J Technol Assess Health Care. 2008;24:244258.
9.World Bank. Definition of the World Bank for lower-middle-income countries. (accessed on March 1, 2012).
10.Oortwijn, W, Mathijssen, J, Banta, D. The role of health technology assessment on pharmaceutical reimbursement in selected middle-income countries. Health Policy. 2010;95:174184.
11.Organisation for Economic Cooperation and Development (OECD). The OECD Health Project. Health Technologies and Decision Making. Paris: OECD; 2005.



Altmetric attention score

Full text views

Total number of HTML views: 0
Total number of PDF views: 0 *
Loading metrics...

Abstract views

Total abstract views: 0 *
Loading metrics...

* Views captured on Cambridge Core between <date>. This data will be updated every 24 hours.

Usage data cannot currently be displayed