OBJECTIVES: Considering the rising costs of health technologies, economic criteria become critical for health technology assessment (HTA). The use of explicit, predefined criteria for economic evaluations enhances transparency, objectivity, and predictability of the process. We aim to identify which organizations, on a global scale, integrate explicit and predefined criteria in their related to health economic analysis during HTA.

METHODS: We conducted a scoping review to identify organizations responsible for the HTA process for decision-making at the national level in any country. The identification of eligible organizations was carried out through a review of members of INAHTA, EUnetHTA, RedETSA, and HTAsiaLink networks, in addition to organizations evaluated in reviews with a similar scope. For each eligible organization, information was extracted on the inclusion of economic factors during decision making and the existence of predefined criteria for judging the results of economic evaluations.

RESULTS: Sixty-nine organizations from 56 countries were identified, of which 66 (96%) consider economic factors for HTA. Fifty-two (79%) conduct cost-effectiveness analysis, 42 (64%) assess budget impact, and one focuses solely on total technology cost. Thirty-four organizations (51%) declare not having criteria for economic evaluation, while 14 (21%), from 12 countries, have explicit criteria; no data was found for 18 organizations (27%). Among the organizations with explicit criteria, 11 (17%) apply willingness-to-pay thresholds in cost-effectiveness evaluations, and five (8%) apply criteria related to budget impact, such as a maximum percentage of budget impact, for decision-making.

CONCLUSIONS: Although most organizations consider economic factors for HTA, many do not have predefined, explicit criteria for decision-making. Among those that present such criteria, there is a predominant use of willingness-to-pay thresholds for cost-effectiveness analyses. The findings of this study also help in identifying complementary factors that can be considered to promote greater systematization and transparency in the decision-making process.