Future of Health Technology Assessment System in Iran: Necessity of Reinforcement in Both Scenarios of Continuation or Relief of Sanctions

Objectives: The Iran’s Health Technology Assessment (HTA) System has been established since 2008. The purpose of this study is to define the future steps needed to promote HTA in Iran by considering possible future events related to health secotor . Methods: A preliminary list of future trends potentially effective on Iran's HTA system was extracted through literature review. These trends were presented to 12 experts and their opinions on the trends and then impact on the future of HTA of Iran were asked through in-depth interviews. The interviews were analyzed using thematic analysis method from two dimensions; firstly, in three categories of capacity building, provision of HTA and supportive mechanisms and secondly according to the critical functions of a health system (i.e. control knobs). Results: The study subjects think that the strengthening HTA system is a must in both scenarios of international sanction’s continuation and its lifting. In the category  of capacity building, alignment trainings to the needs, using the capacity of graduates in conducting HTAs, increasing number of students’ admission, establishment of a PhD program, turning HTA into a public demand and prevent the overuse of medical technologies were elaborated. In the second category which was provision of HTA the following themes were introduced: modernization and equipping health system infrastructure based on the HTA, legitimating HTA for using all health technologies, preventing the introduction of not necessary technologies and technologies that have similar once produced in Iran and imposition HTA in determining of the basic benefit package in across the country. Conclusions: Iran’s is an untapped market due to the economic sanction. If sanction continues, then HTA will be a serious need for resilience of the health system. However, if the sanction be lifted, then it will be needed more on optimizing health system resources for benefiting the population health of Iranians. These steps, in both scenarios, are mostly on institutionalization of HTA which mostly on legitimation and behavioral changes.