Navigating barriers to health technology assessment development in Iran: a qualitative exploration of stakeholder perspectives

BackgroundHealth 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.MethodsThis 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.ResultsSeven 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.ConclusionThis 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.