OBJECTIVES: : The Brazilian’s health system is mainly public. However, a significant private health sector remains in the country, constituted basically by private health insurance companies. This private sector is regulated by the National Regulatory Agency for Private Health Insurance (ANS). Health Technology Assessment (HTA) began to be institutionalized in Brazil in 2000 by the Ministry of Health with the participation of ANS. However, the public and the private sectors have taken different paths. Different HTA processes can generate rework, inefficiency and increase inequities between populations. This study aimed to identify the HTA model implemented in the private health insurance sector, in order to contribute to an integration of this process in the country.

METHODS: ANS documents relating to the HTA process in private health insurance sector were analyzed. All documents are available for public and free access on ANS website. Documents included the process of preparation, updating and periodic reviewing of the list of mandatory health coverage procedures, since it is the process of incorporation of technologies in the sector. It began with the sector's regulatory framework, Law No. 9656 of 1998, and included the last normative published on the subject until December 2021.

RESULTS: The documents analysis allowed to draw a timeline with the main milestones related to the Agency’s HTA process. It revealed an evolution in terms of the organization of the list periodic reviewing process. Although more robust, it still holds weak relation to the guidelines and directions followed by public sector, thus confirming the dichotomy between the two models.

CONCLUSIONS: The international literature suggests the need to promote HTA coordination processes in a country. A deeper knowledge of the differences between public and private HTA processes may help the formulation of future public policies addressed to incorporate health technologies in the country more efficiently and equitably.