In this Insights series, Around the World in HTAs, we shed light on HTA around the world. In this edition, Andrés Pichon-Riviere, Federico Augustovski, and Martina Garau take us to Argentina.
Amid a fragmented healthcare landscape, Argentina’s efforts to institutionalize HTA continue to evolve — offering lessons on ambition, controversy, and innovation.
The Health System in the Country
Argentina, often recognised for its rich culture and dynamic society, also presents a fascinating case study when it comes to its health system. A decentralised and fragmented structure, Argentina’s healthcare is divided among three main sectors: public, social security (“Obras Sociales”), and private insurance. While this diversity offers broad access, it also generates significant disparities in quality, financing, and coordination across the population.
This fragmentation presents unique challenges for efforts aiming to improve system-wide decision-making processes, such as those involving Health Technology Assessment (HTA) and a recently announced national HTA agency.
A Roadmap for New Technologies
Argentina has a long-standing tradition in HTA. As early as the 1990s, a group within the Ministry of Health’s Directorate of Quality engaged in HTA activities. In the 2000s, Argentina became one of the first countries in the region to establish an HTA unit within the Superintendence of Health Services, using HTA to review and update the mandatory health benefit package for social security, known as the “Programa Médico Obligatorio” (PMO). Around the same time, Argentina also became one of the first Latin American countries to host an HTA agency recognised by INAHTA — the Institute for Clinical Effectiveness and Health Policy (IECS).
Despite these early efforts, attempts to formalise HTA governance have faced obstacles. Multiple legislative proposals for creating a national HTA agency have been introduced since the 2010s, but none have advanced through Congress.
A key milestone arrived in 2018 with the establishment of CONETEC — the National Commission for Health Technology Assessment. Created under the Ministry of Health, CONETEC aimed to centralise HTA activities and provide multidisciplinary, evidence-based recommendations. At that time, at IECS developed an Inter American Development Bank–sponsored report to advance the incorporation of economic evidence in the assessment and appraisal of health technologies, and served to inform CONETEC technical manuals. While its influence has grown, especially in the public sector, its recommendations remain non-binding; it has addressed a few health technologies each cycle, and implementation across sectors remains inconsistent.
Current Challenges
By the end of March 2025, the government proposed a new step: the creation of ANEFiTS — the National Agency for the Evaluation of Health Technologies and Innovation. This body would replace CONETEC, with greater autonomy and stronger authority to regulate HTA processes throughout the system. It was announced in a press conference, and the government spokesman stated that a decree with the details, scope, and reach of the agency was going to be published in the official bulletin in the upcoming days. This has still not happened.
In April 2025, the Social Action and Public Health Committee of the National Chamber of Deputies held a session to discuss current legislative projects for creating a national HTA agency, including ANEFiTS. The meeting revealed a broad consensus on the need for HTA to support evidence-based policymaking. However, it also exposed important disagreements regarding the agency’s design and governance.
Several major concerns emerged:
- Binding decisions: In a fragmented system like Argentina’s, many stakeholders (including provincial insurers, PAMI, and private payers) worry about being compelled to adopt decisions without proper representation in the evaluation process.
- Relationship with the regulatory agency (ANMAT): The draft proposal establishes that ANEFiTS should issue evaluations before ANMAT (the regulatory authority) finalises its own assessments — an unusual sequence internationally that raises concerns about regulatory coherence.
- Transparency and participation: Uncertainty remains about how different stakeholders — patients, providers, payers — will be included in evaluations and decision-making processes.
- Impact on pricing: It is unclear whether and how ANEFiTS would influence the pricing of new health technologies, a critical element for ensuring affordability and access.
- Judicial advice role: Argentina’s tradition of strong legal enforcement of healthcare rights adds another layer of complexity, as HTA-based decisions might conflict with judicial rulings demanding coverage of treatments, mostly on an individual, patient-by-patient basis.
Additionally, the question of its “legal power” arose. Though most agreed that a law would make it more legitimate, some recognised that this could slow its creation, and stated the example of the Argentinian regulatory agency ANMAT, a well-recognised agency and leader in Latin America that was created by a decree and was not passed by the congress.
Next Steps for the Argentinian HTA
The future of HTA in Argentina hangs in the balance. Establishing a credible, inclusive, and transparent HTA agency could significantly improve decision-making, promote efficiency, and reduce inequities across the system. However, achieving these goals will require careful institutional design, broad stakeholder engagement, and a strong commitment to transparency and dialogue.
International experiences suggest that creating a successful HTA body goes beyond technical excellence; it requires building trust among all actors — from government and insurers to providers, patients, and the judiciary.
As Argentina moves forward with the ANEFiTS project, the country’s choices will offer valuable lessons for other middle-income nations seeking to balance innovation, equity, and financial sustainability in healthcare.