Evaluating the Maturity Level of Health Technology Assessment in Latin America: A Comparative Qualitative Analysis

OBJECTIVES: This study aimed to review the application of Health Technology Assessment (HTA) in 16 Latin American and Caribbean countries by constructing a Balanced Scorecard (BSC). This facilitated cross-comparison of HTA institutionalization.

METHODS: A comprehensive review of indexed and gray literature from selected LATAM countries was conducted. Databases such as PubMed, LILACS, Google Scholar, and institutional websites were utilized. Information on legislation, HTA processes, and the state of HTA agencies was collected. Countries were evaluated using a BSC on criteria such as linkage of HTA units to policymakers, presence of full-time researchers, use of HTA in policy, and HTA process guidelines. Each criterion was scored on a scale from 0 to 4, with a maximum possible score of 72 points per country.

RESULTS: The study included 16 countries with the following total scores: Brazil (56), Colombia (47), Argentina (46), Uruguay (40), Mexico (36), Peru (31), Chile (30), Ecuador (29), Costa Rica (19), Panama (19), Dominican Republic (19), El Salvador (18), Guatemala (15), Honduras (5), Bolivia (1), and Paraguay (0). Despite the presence of full-time researchers in many countries, there is generally low government budget allocation for HTA. National databases for HTA reports are lacking or have low accessibility, except in Argentina, Brazil, and Peru. Less than half of the countries participate in international HTA networks. Except for Brazil and Colombia, the registration of clinical and economic data for HTA use is very immature. Additionally, the generation of national HTA conferences is very low.

CONCLUSIONS: The implementation of HTA in Latin American countries varies significantly. Main barriers include limited budget allocation, inadequate data registration systems, and low accessibility to HTA reports. Enhancing international collaboration and establishing national HTA databases could significantly improve HTA processes. Policymakers should prioritize resource allocation and support for HTA to ensure informed decision-making in healthcare.