OBJECTIVES: Sustained economic growth in Latin America in the last decade led to an astonishing 50% increase in the middle class. With the empowerment of an increasingly educated and wealthier population, governments have been under pressure to adapt their healthcare models to growing expectations for US/EU health quality standards. As a result, healthcare funding balance between patient Out-Of-Pocket, contributions to private health plans and public via taxation pathways is likely to be subjected to sizable shifts in the near/medium future. This work presents an outlook on the current health care financing and an analysis of potential trends and likely implications in terms of P&MA for new drugs in three case study countries (Brazil, Chile and Colombia). METHODS: Literature review on healthcare financing distribution from 2003 to 2010. Review of political and private initiatives for drug coverage. Hypothesis development on the implications in terms drug’s P&MA. Primary research with payers/proxy-payers. Analyze and compare trends across countries RESULTS: • Chile saw the lowest growth in overall HC expenditure with a clear transfer in the funding distribution from OOP to public sources (39% for both to 33% vs. 48%). • Brazil overall HC expenditure greatly increased (4.99 fold), and since 2005 a moderately sustained transfer from OOP to public funding have been occurring (from 38.6% and 40.1% to 31.6% and 47% in 2010). • In Colombia, funding is dominated by public spending (74.6%) but OOP expenditure has seen the highest growth • HTAs are increasingly involved in drug P&R decisions CONCLUSIONS: Latin American countries are likely to further accommodate ‘hybrid’ systems for healthcare financing. However, as Governments are required to make decisions for funds allocation, there is increasing need for sophisticated tools for drug evaluation and decision making. Increasingly robust HTA agencies are expected to be created, implying downward pressures on price pressures and increased evidence requirements