Latin America is a large and diverse region. Therefore it is no surprise that the development and implementation of pharmacoeconomic (PE) guidelines is proceeding at a different pace in different jurisdictions.

The first three articles in this special issue of Value in Health focusing on Latin America outline the challenges in the development and implementation of guidelines in three country clusters. The three clusters represent countries at different stages in the development and implementation of guidelines at the time when the International Society for Pharmacoeconomics and Outcomes Research (ISPOR) Latin American conference was held in Brazil (September 2009). However there have been rapid changes in some countries during the past year, especially in Colombia. In Argentina, Colombia, Guatemala, Uruguay, and Venezuela, PE guidelines were only under consideration at the time of the conference. In Chile and Mexico, PE guidelines were being developed, or were already developed. In Brazil, PE guidelines were already in the implementation phase and formed the basis of industry submissions to the Office of Economic Regulation at the Brazilian Health Surveillance Agency (ANVISA), the agency that decides on the regulatory approval and reimbursement of drugs and other health technologies [1,2] (see Augustovski et al. for a review and comparison of the PE guidelines currently existing in the Latin American region).

Each step in the development and use of PE guidelines raises its own challenges. In addition, the characteristics of each country's health care system have important influences on the process. Nevertheless, several common lessons were learned.