ObjectivesTo explore health technology assessment (HTA) in Thailand focusing on its institutionalization, key elements for HTA introduction, and HTA contribution to policy.MethodsA review of literature covered a wide range of topics, including the institutionalization of HTA, elements of HTA introduction, and the role of HTA in policy decision making in Thai context. Additional information from the authors’ involvement in the policy decision-making process in Thailand was also considered.ResultsHTA institutionalization comprises processes of introducing HTA, including evidence generation and use in policymaking, building capacity of HTA practitioners, organizations, system infrastructure, and collaborations. In Thailand, HTA has been formally integrated into coverage decisions, including in the development of the National List of Essential Medicines and the Universal Health Coverage Scheme benefits package. Contributing factors included political will and leadership, capacity building on HTA-related disciplines, adequate resources, technical expertise, and data. Conversely, challenges faced included the absence of a governing body and strategic plan for HTA systems development, a lack of formal mechanisms for mobilizing financial support, an inadequate number of HTA researchers in nonprofit institutes, and the rise in advanced biotechnologies.ConclusionsHTA plays an important role in evidence-based healthcare decision making. However, key elements of HTA institutionalization need to be strengthened, especially governance structure and policy for HTA systems development, building and retaining capacity of HTA practitioners to meet demand, addressing the challenges of complex and highly innovative health interventions. Lessons learned from the Thai experience may be used as guidance for HTA institutionalization in other developing countries.

health outcomes. However, this study demonstrates that with the same budget currently invested in the program, the changes proposed will result in improvements on the current low uptake and poor coverage, thus yielding cost savings for the government and a possibility to reallocate resources to the country's priority health concerns, consequently leading to better health outcomes.

HighlightsPCV13 and PCV10 are both cost-effective in Bhutan.PCV13 yields better health outcomes and slightly more cost than PCV10.Introducing PCV would reduce the workload of scarce medical specialists in Bhutan.