Health technology assessment in an argentinean province: adapting existing tools

This study reports on the development of a critical process for health technologies incorporation concerning an Argentinean Provincial Ministry of Health (MOH) in collaboration with the University of Lanús from 2008 to 2010.

We describe the approach developed to adapt selected international experiences to provincial scenario. Bibliographic review, regulations examination, key informants interviews and iterative adjustments after various stages of consultation and consensus building with main local players, contribution from foreign experts, and piloting of process and instruments for ultimate fine-tuning are described. We examine final proposal in the light of new updated studies.

Analysis of regulations revealed that rules governing the provincial system were historically linked to administrative resolutions in relation to procurement with poor consideration to clinical, epidemiological, organizational, and health policy aspects. Key informants from hospitals, MOH, and other governmental agencies agreed on the lack of a process capable of guaranteeing a decision about health technology incorporation based on a transparent use of the best available information, ready to deal with competitive pressures. This adaptation provided a structured and explicit process (introduction, implementation, and development) as well as essential and supporting tools.

MOH adopted the proposal for its progressive implementation while institutional evaluation capacity develops. Further studies are needed on the value placed on health technology assessment-based processes and recommendations by clinicians, managers, policy makers, and patients.