Colombian health system on its way to improve allocation efficiency—transition from a health sector reform to the settlement of an HTA Agency

Abstract

Over the past 20 years, Colombia has invested major efforts in ensuring universal health care access to its citizens while facing epidemiological transition and demographic changes. The country, as any other region in the world, is challenged by financial constraints and market pressures for entry of new and frequently costly technologies. After the 1993 health sector reform, Colombian citizens are entitled to health care access via mandatory health insurance through a benefits plan. Inclusions to this plan were the first attempt to establish a formal methodology of health technology assessment. Later on, the dynamics of insurers, market pressure, reimbursement decisions, and judicial actions drove the government toward the formulation of an infrastructure to improve efficiency in the use of resources. This article accounts for the steps undertaken by the Colombian health system until the establishment of a health technology assessment body and outlines the most important issues that can be learned from this process.