In Latin America, social security and public sectors represent the largest financiers and providers of health care. Many countries in the region have compulsory packages of basic health care benefits. As part of an effort to improve quality of care and access, several health technology assessment agencies, both governmental and academia, among a number of Latin American countries have been formally established in the past few years. Several Latin American countries have recently developed and published methodological guidelines in economic evaluation, indicating that there is a growing interest in evaluating health-related products, drugs, and technologies used by the population. Presentations on the health care system and the role of health technology assessment, pharmacoeconomics, and risk sharing policies, from the public sector perspective, in the Latin American countries Argentina, Brazil, Colombia, and Mexico were made at the 3rd Latin American ISPOR Conference held in Mexico City in 2011 and are discussed in this article. In conclusion, there is a clear need for Latin American countries to evaluate the value of new technologies that are being incorporated into their health care system. In addition, health technology assessment guidelines are important for their local needs in terms of regulation along with common country unions. In the future, the Latin American region needs to increase drug access along with implementing cost-containment measures to improve quality and health outcomes.
The health care system in Latin America is highly fragmented and has subsystems that target specific strata of the population grouped by social class, income, occupation, type of employment, ethnic origin, or urban or rural residence, producing a phenomenon of population segregation that has led to higher segmentation, fragmentation, and low efficiency [1].
To address the fragmentation of the health care systems in the region, the Organizacion Panamericana del Salud (Pan-American Health Organization) created a new health technology assessment (HTA) network in the Americas (Red de Evaluación de Tecnologías Sanitarias), which triggered the HTA development in Latin America [1] and [2]. As part of this initiative, countries representing Mercosur (Brazil, Argentina, Paraguay, and Uruguay) and Grupo Andino (Bolivia, Chile, Colombia, Ecuador, Peru, and Venezuela) commenced focusing their efforts on the implementation of HTA. Currently, Mercosur has guidelines for HTA methods, new technologies, and economic evaluation. The Grupo Andino is also working toward developing methodological HTA guidelines [1] and [2].
There are several HTA agencies, both governmental and academia, among a number of Latin American countries, which were formally established in the last couple of years. Countries such as Cuba, Brazil, and Mexico have recently developed and published methodological guidelines in economic evaluation, indicating that there is a growing interest in evaluating health-related products, drugs, and technologies used by the population [3] and [4].
In 2009, during the 2nd ISPOR Latin America Conference held in Rio de Janeiro, Brazil, the first symposia was held to discuss questions on HTAs, decision-making reimbursement, and pharmacoeconomics to support each country's needs at that time, with a focus on four Latin American countries (Argentina, Brazil, Colombia, and Mexico) [5]. To provide an update on the information presented in 2009, at the 3rd Latin America Conference held in 2011 in Mexico City, Mexico, a second symposia served to discuss the health care reimbursement environment and risk-sharing agreements for the same four Latin American countries (Argentina, Brazil, Colombia, and Mexico).
In Latin America, social security and public sectors represent the largest financiers and providers of health care. Many countries in Latin America have compulsory packages of basic health care benefits. What follows are country-specific updates of the public sector environment in Argentina, Brazil, Colombia, and Mexico concerned with the reimbursement environment and HTA based on the presentations and discussions at the 2011 3rd Latin American ISPOR Conference held in Mexico City [6].
