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Navigating Barriers to Health Technology Assessment Development in Iran: A Qualitative Exploration of Stakeholder Perspectives Publisher



Behzadifar M1 ; Shahabi S2 ; Bakhtiari A3 ; Azari S4 ; Yarahmadi M5 ; Aryankhesal A6 ; Darvishi Teli B7 ; Behzadifar M1
Authors
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Authors Affiliations
  1. 1. Social Determinants of Health Research Center, Lorestan University of Medical Sciences, Khorramabad, Iran
  2. 2. Health Policy Research Center, Institute of Health, Shiraz University of Medical Sciences, Shiraz, Iran
  3. 3. Health Equity Research Center (HERC), Tehran University of Medical Sciences (TUMS), Tehran, Iran
  4. 4. Hospital Management Research Center, Health Management Research Institute, Iran University of Medical Sciences, Tehran, Iran
  5. 5. Department of Medical Parasitology and Mycology, Lorestan University of Medical Sciences, Khorramabad, Iran
  6. 6. School of Health Sciences, Faculty of Medicine and Health Sciences, University of East Anglia, Norwich, United Kingdom
  7. 7. Health Management and Economics Research Center, School of Health Management and Information Sciences, Iran University of Medical Sciences, Tehran, Iran

Source: Archives of Public Health Published:2025


Abstract

Background: Health Technology Assessment (HTA) plays a crucial role in informing healthcare policy and decision-making, especially in low- and middle-income countries like Iran. Despite its potential, the development of HTA in Iran faces significant barriers due to political, financial, technical, and social challenges. This study aims to explore stakeholder perspectives on the barriers hindering HTA development in Iran and to identify strategies for overcoming these obstacles. Methods: This qualitative study utilized semi-structured interviews to collect data from 18 stakeholders involved in the healthcare sector in Iran, including policymakers, healthcare professionals, and experts in health economics and policy. Thematic analysis was applied to identify key barriers and overarching themes related to HTA development. Results: Seven overarching themes emerged: [1] lack of a comprehensive legal and regulatory framework [2], financial constraints and limited funding [3], shortage of trained professionals and organizational resistance [4], low public and professional awareness [5], weak technical infrastructure and data systems [6], poor inter-organizational collaboration, and [7] political interference in health decision-making. These barriers hinder the effective integration of HTA into Iran’s healthcare system. Despite these barriers, participants suggested actionable recommendations, including strengthening governance structures, increasing financial investment, enhancing stakeholder engagement, and improving technical capacity. Conclusion: This study highlights the unique misalignment between HTA priorities and national health policies in Iran, barriers less frequently reported in other LMICs. Addressing these barriers through targeted policy reforms, investment in human resources, and enhanced collaboration could facilitate HTA development and improve healthcare decision-making in Iran. © The Author(s) 2025.
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