OBJECTIVES: To segment seven national Asia-Pacific Health Technology Assessment (HTA) into different evolutionary HTA archetypes. METHODS: Using a quantitative scale based on 18 best-practice HTA principles, we designed a weighted scoring algorithm that evaluates HTA agencies against six domains indicative of HTA maturity: transparency, process, technical, equity, speed and implementation. We segmented 67 HTA agencies into five evolutionary archetypes. In the order of maturity, these archetypes (overall score range in parenthesis): price managers (1-7), formulary managers (8-37), cost advisors (38-64), value appraisers (65-73), and value implementers (74-81). Here we present the segmentation analysis of seven national HTA agencies - Australia, China, Japan, Singapore, South Korea, Taiwan, and Thailand. RESULTS: Our analysis, placed Australia (overall score: 75) into the most mature archetype value implementers, followed by South Korea (overall score: 70) under value appraisers, Taiwan (overall score: 38) under cost advisors, Japan, Thailand, and China (overall score: 36, 34, and 25, respectively) under formulary managers, and Singapore (overall score: 5) as price managers. The higher scores of Australia and South Korea over others were attributed to better performance in critical domains of HTA maturity: transparency, process, equity, and implementation. HTA archetype behavior analysis indicated that in mature archetypes (value implementers, value appraisers) HTA decisions are not only based on budget impact but also considers efficacy, safety, cost effectiveness and innovation. While cost advisors consider efficacy, safety, and cost effectiveness as decision drivers, and act only as advisor for formulary management. By contrast, price managers play limited role in HTA implementation, with decisions driven only by budget impact.  CONCLUSIONS: The evolution of HTA is not a step wise process of gaining capability, but is a systematic approach of developing transparency, equity, and implementation. While technical and process are just foundations to become an HTA agency. Countries can fast transit through archetypes by making upgrades to their processes.