Presentation (CTI)

OBJECTIVES: HTA informs access to high-cost medicines in Latin America, yet institutions, evidence expectations and the routes from assessment to funded access differ across countries. We compared decision frameworks, evidence requirements and access linkages across eight Latin American healthcare systems.
METHODS: A targeted cross-country review covered Argentina, Brazil, Colombia, Costa Rica, Mexico, Panama, Peru and Uruguay. Peer-reviewed literature, official HTA documents, payer guidance, legislation and grey literature were reviewed from the past decade. A pre-defined framework extracted institutional model, evaluation route, evidence and economic-evaluation requirements, budget-impact expectations, timelines and the linkage between HTA recommendation and funded access. Findings were synthesized narratively.
RESULTS: Three patterns emerged. First, HTA institutionalization differed widely: Brazil and Uruguay operate more centralized, formalized pathways, whereas Costa Rica and Panama rely on payer-governance or committee-based review; Argentina sits between these, combining national CONETEC guidance with decentralized payer implementation. Second, the weight given to economic evidence varied: Brazil and Peru apply explicit or published cost-effectiveness benchmarks, and Uruguay's national coverage fund requires formal ICER-based evaluation without a declared threshold, while Colombia and Mexico use HTA outputs mainly to inform pricing, formulary listing and negotiation. Third, the link between assessment and funded access was fragmented in most systems: favorable technical findings still required budget approval, procurement and payer-level implementation; e.g., in Colombia and Mexico assessment shaped price regulation or formulary inclusion rather than serving as a single reimbursement gate. Budget impact and affordability were central decision drivers across all systems.
CONCLUSIONS: HTA in Latin America follows no single regional model. Favorable assessment outcomes do not automatically translate into funded patient access, as pricing, budget allocation, procurement and payer implementation often remain separate downstream steps. Cross-country access strategies should therefore reflect each system's decision architecture, evidence expectations and affordability, treating HTA approval as one step in the long access pathway.