TY - JOUR T1 - Adaptive health technology assessment to facilitate priority setting in low- and middle-income countries JF - BMJ Global Health JO - BMJ Global Health DO - 10.1136/bmjgh-2020-004549 VL - 6 IS - 4 SP - e004549 AU - Cassandra Nemzoff AU - Francis Ruiz AU - Kalipso Chalkidou AU - Abha Mehndiratta AU - Lorna Guinness AU - Francoise Cluzeau AU - Hiral Shah Y1 - 2021/04/01 UR - http://gh.bmj.com/content/6/4/e004549.abstract N2 - Summary boxThere is a growing appetite for health technology assessment (HTA) in low-and middle-income countries (LMICs) to better inform healthcare priority setting.However, LMICs are sometimes constrained by limited capacity, data, time and priority setting governance structures to carry out HTA.LMICs may benefit from adaptive HTA (aHTA), which we define as a broad term for HTA methods and processes which are fit-for-purpose and focus on context-specific practicality constraints.aHTA can leverage or adapt available international data, economic evaluations, models and/or decisions from the published literature or established HTA agencies to inform policy decisions, while accounting for uncertainty considerations.aHTA should be pragmatic, though still informed by key HTA principles such as transparency, independence, consultation and contestability.More work is needed to design, support and test bespoke aHTA for LMICs to better understand its strengths and limitations.Traditional health technology assessment (HTA) is a policy-based research process, which aims to improve the efficiency and equity of the healthcare system with the limited financial resources available in healthcare.1 In various countries, traditional HTA has been ‘institutionalised’—through the development of dedicated agencies with accepted norms and rules that guide explicit priority setting—over years or decades. These agencies use time-consuming, data intensive and systematic methods and processes which require health economics expertise and resources to make recommendations on how to allocate finite resources.2There is a growing appetite for HTA and its eventual institutionalisation in low- and-middle income countries (LMICs) driven in part by WHO’s recommendation for it to be a critical component to achieving universal health coverage.3 While there are notable LMIC exceptions of introducing and institutionalising HTA (eg, Thailand, Colombia, Brazil and India), others may be constrained by limited technical and administrative capacity, paucity of data, time and governance structures to carry out HTA.4A more pragmatic approach … ER -