BACKGROUND:  The increasing focus on healthcare costs, aging of populations and rising costs of drug development require an effective approach to ensure the rational uptake and diffusion of technologies by health systems. Health stakeholders want safe, appropriate and effective healthcare with enduring results at a reasonable cost, particularly in environments where resources are scarce. In spite of much research, methodologies and recommendations, a simple solution to make budget allocations or procurement decisions is still needed by many decision makers. APPROACH: A user-friendly and read-do checklist could facilitate the assessment of cost-effectiveness of technologies, particularly new, innovative high cost drugs. The aeronautical industry (pre-flight safety checklist), World Health Organization/Harvard School of Public Health (pre-surgical safety checklist) and public health services (pre-disaster or disease preparedness checklists) have successfully prevented and reduced air traffic accidents and morbidity and mortality secondary to surgical interventions, diseases and natural disasters through the implementation of safety checklists. PRACTICAL IMPLICATIONS: In pharmacoeconomics, as in aviation, medicine and public health, a checklist can help ensure consistency and completeness in carrying out the complex technology selection task improving the decision maker´s communication and consistency of information and data, facilitating the decision-making process and determining the most cost-effective options. This checklist could also be a useful tool to negotiate value added services, managed-entry agreements and risk-sharing arrangements to reduce the cost of drugs.  CONCLUSIONS: A generic “New Technology Cost-Effectiveness Checklist”, intended to be modified as needed to fit local requirements, could guide evidence-based decisions in resource-limited settings. In turn, it may become the tool to reach the universal goals of patients, providers, payers and policy-makers to (1) get the best drug and technology quality at the lowest cost and with reasonable access, and (2) enhance healthcare partnerships and solutions towards improved individual and population health outcomes.