OBJECTIVES: This study appraised the health professionals and managers’ value judgments in Brazilian HTA process, through a new method of research that addresses clinical scenarios to simulate real world dilemmas and support budget allocation. The decisions should be made under clinical and epidemiological aspects, and, also, economic, social, ethical and cultural factors. The main objective was to evaluate how these factors have influenced the decision makers in HTA resources allocation. We agreed to call this model by Decision Making Clinical Scenarios (DMCS).  METHODS: This study was conducted through a decision making questionnaire with four clinical scenarios involving HTA. These scenarios introduced issues involving value judgments, preferences and structuring choices, considering a severe budget restraint. The presented trade-offs were related to health policies, such as budget impact, sources of funding, eligible patients, technology characteristics and disease epidemiology. RESULTS: The results showed a conservative trend. In all three scenarios involving some form of technological incorporation, the most chosen option was to avoid incorporation. Alternatives of funding, as reduction/extinction of current healthcare programs and creation of a new tax, were not accepted as solutions. In budget allocation between prevention and treatment programs, respondents were suited to a preventive long-term strategy. CONCLUSIONS: The scenarios have been shown understandable. The absolute scarcity of resources clearly influenced the results. In search of a paradigm for decision making, most of respondents prioritized to save resources, instead of incorporating the technologies. We concluded that managers are not guided only by clinical benefit of a decision. They valorized the importance of funding mechanisms and budget control that enable incorporation, considering economic, social, ethical, and structural aspects. This study model seems to be useful to evaluate the trends of conduct of decision makers. This model can be used in further researches, bringing different factors and criteria into discussion, through clinical real world situations.