OBJECTIVES: To determine which between the 2013 South African Guideline for Pharmacoeconomic Submissions (SAGPS) and the 2021 draft South African Health Technology Assessment Methods Guide (SAHTAMG) were more useful for evaluation of medicines and decisions on selecting medicines for coverage and reimbursement.

METHODS: The evidence and information requirements for the SAGPS was previously evaluated using the European Network for Health Technology Assessment Core Model, version 3.0 (the Model^®). The exercise was repeated for the more recent SAHTAMG. The guidelines' content were deconstructed in Excel^® according to the nine domains in the Model^®, their respective topics and questions (issues). Three rating criteria were used for each issue: "Yes - guideline completely requires the same / similar information as the Model^®, "No - guideline does not the require the same / similar information as the Model^® and "Partly - guideline only requires some of the information as the Model^®.

RESULTS: The SAHTA encompasses more stages and analyses than the SAGPS. Overall, the SAHTAMG was more comprehensive than the SAGPS: it performed better than the SAGPS in 7 out of 9 domains and required much more thorough consideration of the ethical, organisational and patient aspects of introducing a new technology, in particular. Neither guideline performed well in the safety and legal domains. Differences between the guidelines may be explained by their different scopes and intended audiences: the SAGPS is intended for the private health sector and the SAHTAMG for the public health sector.

CONCLUSIONS: The SAHTAMG, due to its comprehensive nature, may be more appropriate for HTA decision making for medicines reimbursement in South Africa. The need for a separate, less comprehensive guideline in the private health sector should be reconsidered.