Health Technology Assessment of Medical Devices Through the Ad Hoc Methodology: Experience of the Social Health Insurance in Peru
Keywords:
Peru, Public Health, Health Management, Evidence-Based Medicine, Medical Devices, Health Technology AssessmentAbstract
Introduction: Health technology assessment (HTA) plays a key role in supporting decisions regarding the adoption and use of healthcare technologies. Medical devices pose unique challenges because of their technological heterogeneity, rapid innovation, and dependence on implementation settings, requiring adapted assessment methodologies.
Objective: To describe the experience of implementing an ad hoc methodology for health technology assessment of medical devices within the Peruvian Social Health Insurance system (EsSalud).
Materials and Methods: A retrospective descriptive observational study was conducted using HTA reports of medical devices published by the Institute for Health Technology Assessment and Research (IETSI) between 2020 and 2025. The methodology included PICO question development and validation, evidence search and selection, critical appraisal, evidence synthesis, methodological review, and preparation of the final recommendation. Institutional, clinical, and technological variables were analyzed using descriptive statistics.
Results: A total of 76 HTA reports were included; 37 (48.7%) received favorable recommendations and 39 (51.3%) unfavorable recommendations. The highest number of assessments occurred in 2023 and 2025. Most requests originated from the Rebagliati, Almenara, and Sabogal healthcare networks and the National Cardiovascular Institute (INCOR). Surgical specialties and adult populations predominated. Favorable recommendations were mainly related to cardiology/cardiovascular surgery, traumatology, interventional oncology, and therapeutic gastroenterology technologies.
Conclusions: The ad hoc methodology enabled timely and structured assessments of medical devices through an evidence-based institutional process supported by methodological review and evaluation of institutional applicability, strengthening transparent and context-specific decision-making within EsSalud.
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