OBJECTIVES: to identify the key trends in healthcare spending in Brazil in 2015.  METHODS: Review of the Ministry of Health (for programs), Ministry of Planning (for budget) and Workd Bank (for GDP growth) reports as well as recently published financial information on Bloomberg and Valor (Brazilian newspaper) on Federal and States spending. RESULTS: The economic program established by the Brazilian government forecasts growth will return only in 2016. It is worth remembering that in 2014 the GDP growth in Brazil was very close to nil. In 2015, economists expect the GDP increase to be below 1%. The Ministry of Health budget in 2014 was US$ 45.6 billion vs. 2015: US 41.2 billion, a 9.6% reduction caused by increased inflation and the devaluation of the Brazilian real against the American dollar. Moreover, with the reduction in the price of oil some states, such as Rio de Janeiro, might lose US$ 750 million in royalties. In the private setting, ANS, the Federal agency that regulates private payers (HMOS, healthcare insurers, etc.), is getting ready this year to work on the update of the Minimum Mandatory Coverage List valid January 2016 on. In a sector in which 80% of the health plans are either collective (unions) or paid by companies, thus, dependent on the expansion of the economy, the willingness to pay for the incorporation of new technologies would probably be low. CONCLUSIONS:  With a struggling economy ahead and consequently smaller budgets, not only does the Federal Government foresee adjustments in public spending but also do State Governments. Context indicates that dialogue and flexibility among healthcare players will be needed more than ever.