OBJECTIVES: Health technology assessment (HTA) is growing in low and middle-income countries to ensure optimal use of limited resources. The study aimed to provide an overview of Turkey's progress since establishing the first HTA agency in 2012. Significant changes await the country’s HTA system, hence the review is timely.

METHODS: National HTA Directive and the HTA reports were accessed on the national HTA agency's website. The national HTA Directive and the HTA reports were assessed against the key principles of HTA by two researchers independently, and any discrepancies were dissolved through discussion.

RESULTS: The study included eight national HTA reports. Compliance with the principles was judged poor to moderate, and significant methodological limitations were identified. The reports were inconsistent regarding the scope and the HTA assessment criteria. The link between HTA findings, HTA decision-making and health policies were not clear.

CONCLUSIONS: The national HTA Directive does not provide a full guidance for HTA and considers only a few key principles. The inconsistencies between the reports and the methodological limitations demonstrate the need for comprehensive national HTA guidelines. Improving the characteristics of the HTA reports might impact implementation. A key issue is transparency regarding priority setting, the HTA process and decision-making. The study proposes some suggestions to overcome the limitations in future HTA activities.