Nowadays, countries strive to deliver universal health coverage but must make choices on which health technologies and interventions to invest in, given their limited resources. In this context, health technology assessment (HTA) becomes essential to systematically evaluate the properties, effects, and impacts of the informed strategies. To address the challenges of ensuring health system sustainability, involving new evidence, and uncertainty in HTA, a recently published article by Kirwin et al¹ proposed a framework for a life-cycle HTA (LC-HTA). The framework emphasizes the need for de novo models conducted by HTA agencies and proposes using the risk-based price in decision making when a high level of uncertainty exists. This approach can bring many advantages as mentioned in the article; nevertheless, it also presents some methodological limitations and challenges when applied as a routine activity in the HTA processes. We reflect on these aspects and how they can be compromised given the diversity in organization and functionality of HTA agencies worldwide.