OBJECTIVES: This paper aims to study the pharmaceutical  reimbursement/Coverage decision making processes in Jordan to highlight the importance of conducting formalized technology assessments METHODS: To review publically available data regarding the reimbursement/Coverage decision making processes in Jordan through searching related organization's websites and publically available regulations. RESULTS:   Jordan is characterized with a fragmented health care system. Pharmaceutical registration and pricing are under the responsibility of the JFDA. Furthermore, it is responsible about medication selection for the Rational Drug List (the national formulary). The medication supply chain differs between the public and the private sectors in term of process and out puts. The medication selection process is not governed by criteria and not empowered by an independent review body to support decision making by the national appraisal committee (national P&T). The rational drug list is publically available but without details of the decision or the processes of decision making process. Listing of new medication is wide without indication specification or date of listing. The role of cost-effectiveness is limited and the tender prices are not linked to any type of cost effectiveness analysis CONCLUSIONS: The National Agenda, the National health Policy and the National Drug Policy tackled the high health expenditure in Jordan as an essential priority. This challenged is due to the characteristics of the Jordanian health care system that is fragmented with a divided funding system between public and private sectors. A more formalized medication selection processes empowered with drug information services that provide evidence based data and analysis in the form of technology assessment would play a role in decreasing healthcare expenditures. All of these recommendations should move parallel with improving the level of transparency and patient engagement.