Framework for Health Technology Assessment for Universal Cancer Care in India

India faces a growing cancer burden, with late diagnosis, high treatment costs, and out-of-pocket expenditure posing challenges to achieving universal cancer care (UCC). This paper examines the role of health technology assessment (HTA) in informing priority setting, strategic purchasing, and resource allocation for cancer care in India, and discusses its contribution toward achieving UCC. We undertook a targeted review of published literature and policy documents describing India's UCC initiatives and institutionalization of HTA. Bibliographic databases were searched to identify HTA and economic evaluation studies in oncology conducted under the aegis of Health Technology Assessment in India (HTAIn), the central HTA agency of the Government of India. The HTAIn website was additionally reviewed to identify completed oncology HTA reports. Evidence was synthesized narratively to describe the applications of HTA and key challenges in translating HTA evidence into policy and practice. HTA has informed multiple dimensions of publicly financed cancer care in India, including selection of interventions for health benefit packages under Ayushman Bharat Pradhan Mantri Jan Aarogya Yojana, development and refinement of treatment and program guidelines, and generation of value-based prices to inform pricing and reimbursement decisions. Applications span cancer prevention and screening, pharmaceuticals, radiotherapy, and other treatment modalities. HTA also provides a framework for considering efficiency, equity, financial risk protection, and health-system implications when allocating limited resources. HTA can play a pivotal role in advancing UCC in India by supporting transparent, evidence-informed priority setting and strategic purchasing. Strengthening mechanisms for timely HTA, evidence uptake, periodic reassessment, and linkage with reimbursement and pricing decisions are important to maximizing health gains, promoting equity, and reducing financial hardship.