Evidence map›Paper›PMID 41074129›Full record

ArticleHealth research policy and systems2025

Political analysis of health technology assessment implementation in Iran.

Meysam Behzadifar, Samad Azari, Ahad Bakhtiari, Saeed Shahabi, Mariano Martini, Mohammad Yarahmadi, Masoud Behzadifar

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Article in Health research policy and systems, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

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3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

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4 · The record

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PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors.

Meysam BehzadifarSocial Determinants of Health Research Center, Lorestan University of Medical Sciences, Khorramabad, Iran.
Samad AzariHealth Management and Economics Research Center, Health Management Research Institute, Iran University of Medical Sciences, Tehran, Iran.
Ahad BakhtiariHealth Equity Research Center (HERC), Tehran University of Medical Sciences (TUMS), Tehran, Iran.
Saeed ShahabiHealth Policy Research Center, Institute of Health, Shiraz University of Medical Sciences, Shiraz, Iran.
Mariano MartiniDepartment of Health Sciences, University of Genoa, Genoa, Italy.
Mohammad YarahmadiDepartment of Medical Parasitology and Mycology, Lorestan University of Medical Sciences, Khorramabad, Iran.
Masoud BehzadifarSocial Determinants of Health Research Center, Lorestan University of Medical Sciences, Khorramabad, Iran. masoudbehzadifar@gmail.com.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundHealth technology assessment (HTA) is a critical tool for evidence-based decision-making in healthcare systems, yet its implementation in low- and middle-income countries such as Iran remains understudied. This study examines the political dynamics of HTA implementation in Iran, focussing on the roles, interests and interactions of key stakeholders. By addressing the gap in understanding the political challenges and opportunities associated with HTA implementation, this study aims to provide actionable insights for policymakers and practitioners.

methodsA qualitative study design was employed, using in-depth semi-structured interviews with 19 stakeholders from 6 categories: interest groups, political leaders, donors, financial decision-makers, beneficiaries and bureaucracies. Participants were selected through purposive sampling to ensure representation across sectors. Data were analysed using thematic analysis, guided by the political analysis framework of Campos and Reich. The study adhered to the Consolidated Criteria for Reporting Qualitative Research (COREQ) checklist to ensure methodological rigour.

resultsThe findings reveal significant barriers to HTA implementation in Iran, including limited political will, competing priorities, inter-agency coordination challenges and concerns about equity and access. Interest groups, such as physicians and pharmacists, expressed concerns about restricted clinical autonomy and limited access to innovative treatments. Political leaders emphasized the difficulty of prioritizing HTA amidst competing healthcare and economic issues, whilst donors highlighted the need for alignment with national priorities and long-term sustainability. Financial decision-makers acknowledged the potential of HTA to improve resource allocation but raised concerns about budgetary constraints. Beneficiaries stressed the importance of transparency and inclusion, and bureaucrats underscored the need for stronger leadership and capacity building.

conclusionsThe study underscores the importance of strong political leadership, stakeholder engagement and institutional capacity building for successful HTA implementation in Iran. Practical steps include strengthening inter-agency coordination mechanisms, ensuring transparent and inclusive decision-making processes, aligning donor support with national health priorities and investing in training programs to build technical capacity within government agencies. By addressing these challenges, policymakers can enhance the integration of HTA into the health system, ensuring efficient and equitable resource allocation.

Indexed as

Decision MakingDelivery of Health CareHealth PolicyPoliticsTechnology Assessment, BiomedicalAdministrative PersonnelHealth PrioritiesHumansInterviews as TopicIranLeadershipPolicy MakingQualitative ResearchStakeholder ParticipationHealth policyHealth technology assessmentImplementation challengesIranPolitical analysisResource allocation

Identifiers

PMID41074129
PMCPMC12512436

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LicenceCC BY-NC-ND
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.