OBJECTIVES : As the HTA ecosystem in India is evolving, it is worthwhile to review HTA practices in other countries. Aim of this project was to compare HTA dossiers of agencies from three countries on a similar research topic.METHODS : An observational study was carried out on the HTA reports available on the public domain on breast cancer screening/surveillance programme for India, Ontario, and Ireland. The reports were compared using 3 criteria: 1. Scope of Literature Search 2. Presentation of Results and 3. Clarity in Recommendations to ease decision making. All three aspects of the review of HTA reports from three countries were performed by three separate observers with subject matter expertise from medical sciences, information science and research methodology respectively. To avoid any bias, the same reports were reviewed by the three observers from the respective domain and results from both the reviews were verified by senior researchers and were compiled.RESULTS : 1) All three reports had a comprehensive literature search except a detailed description of search methods in non-Indian HTAs. 2) Diagnostic accuracy related outcomes were common in all three reports. However, unlike the other two reports, Indian HTA lacked in terms of safety outcomes in clinical effectiveness review. Except Ontario HTA with BI-RAD score-based screening, no other report was found with mention of any standard screening scale. Ontario HTA used secondary economic evidence for review, whereas Indian and Ireland HTA were found with the Markov model and Markov model plus budget impact analysis with simulation software, respectively. 3)Except Ireland's case with dedicated and detailed recommendations report from HTA findings, Indian HTA and Ontario HTA were found to incorporate recommendations in abstract/executive summary.CONCLUSIONS : Indian HTA’s report quality could be improved with elaboration in methodology as well as justification of the recommendation made in its HTA report likewise the case with rest countries.