Objectives Building an efficient health technology assessment (HTA) system requires
significant effort and political commitment, in addition to human and financial resources.
Expectations of what HTA can offer to middle-income countries (MICs) are continuously
rising, which drives health policymakers to raise the question of whether HTA could
help secure the financial sustainability needed to implement universal health coverage.
In this study, we explored the impact HTA adoption may have on the countries and its
impact on health system objectives, as well as transferability of benefits and drawbacks
observed in higher-income to middle-income countries. Methods We utilized secondary
data from a systematic literature review and primary data by disseminating a survey
among local stakeholders in three MICs across three continents to capture their perspective
on the impact of HTA implementation from a local context. Results It was evident from
the results of both the literature review and survey that the positive impacts of
HTA implementation outweigh the negative impacts. Most of the reviewed literature
discussed the impact of HTA on the intermediate objectives of the health finance policy
in relation to the broad health system goals. According to the survey respondents,
the most evident benefit of HTA implementation is improving the transparency and accountability
of healthcare decisions. Conclusions Overall, HTA implementation can introduce a myriad
of benefits to healthcare systems in MICs as well. Our findings show that while HTA
implementation may have the potential to generate cost savings in specific areas,
there is no guarantee that HTA can generate savings at the macro level. Public Interest
Summary Health technologies (medicines, devices, and interventions) are rapidly increasing
in complexity and cost. Health Technology Assessment (HTA) guides healthcare decision-makers
in choosing the most suitable, effective, affordable, and acceptable health technology
to invest limited healthcare resources. However, healthcare decision-makers in middle-income
countries (MICS) are still uncertain about whether adopting HTA would help them achieve
the financial sustainability needed to achieve universal health coverage. Therefore
we sought to gather evidence on how HTA has affected the health systems of countries
that have already adopted it by reviewing published research reports. In addition,
healthcare decision-makers from three MICs were questioned about their perception
of how HTA implementation will affect their country's health system. We found that
the positive effects of HTA implementation outweigh the negative ones; specifically,
the transparency and accountability of decisions are improved. However, although HTA
implementation may generate cost savings in specific areas, it may not significantly
contribute to overall financial sustainability.
