Overview
In Moldova, we supported the development of a national roadmap for institutionalising HTA to strengthen evidence-informed decision-making in the health system. The initiative focused on building the governance, procedural and technical foundations required to introduce HTA in a structured and sustainable way.
Rather than immediately launching full HTA implementation, we worked with national stakeholders to design a phased reform strategy emphasising institutional design, stakeholder alignment and capacity development. The roadmap provides a sequenced approach for embedding HTA within national health financing and benefit package decision processes.
Context & Objectives
Moldova faces fiscal constraints, rising pharmaceutical expenditures and increasing demand for new health technologies. While technical expertise existed in parts of the system, decision-making processes for reimbursement and inclusion of services lacked formal HTA structures.
The Ministry of Health therefore sought to:
- Assess the readiness of the system for HTA implementation
- Identify institutional gaps and capacity needs
- Define governance structures for HTA appraisal
- Develop a realistic, phased implementation strategy
- Align HTA development with broader health system reforms
The objective was not only technical capacity building, but institutionalisation of transparent and structured priority setting mechanisms.
Approach & Methods Used
- Situational analysis of existing decision-making processes
- Stakeholder mapping across ministries, insurance bodies and academic institutions
- Assessment of technical and institutional HTA capacity
- Structured consultations with policymakers and experts
- Development of a phased implementation roadmap
- Definition of roles and responsibilities for HTA governance
- Alignment of HTA development with benefit package revision cycles
- The approach emphasised gradual institutional embedding rather than rapid technical rollout.
Outcomes
The roadmap clarified the institutional pathway for HTA development in Moldova and provided a realistic sequencing strategy. It identified governance anchoring, methodological standardisation and capacity building as key priorities.
Key lessons include:
- Institutional readiness assessment is essential before HTA rollout
- Clear mandates and governance structures prevent fragmentation
- Capacity building must accompany methodological development
- Phased implementation increases feasibility and sustainability
- Early stakeholder engagement strengthens ownership of reform
Moldova’s experience illustrates how middle-income countries can move toward structured priority setting through careful institutional design and sequencing.
As a follow-up project, we supported the School of Public Health Management in Moldova to develop an introductory course on HTA. The course targets first- and second-year master’s students, and health professionals enrolled in continuing education. In the first year (2024), 49 master’s students and 26 health professionals were trained.
Collaborating Partners
Our work in Moldova has been done in collaboration with the Ministry of Health, CNAM, and the School of Public Health Management in the Republic of Moldova.
Related Publications & Reports
- Surgey G, Curocichin G, Garabajiu M, Novakovic T, Pana A, Oortwijn W. The Development of a Roadmap for Health Technology Assessment Implementation in Moldova. F1000Research. 2024;13:518.
- Chitan E, Timotin A, Anisei A, Volovei I, Lozan O. PP58 Enhancing health technology assessment understanding through targeted educational programs. Int J Technol Assess Health Care. 2025;40(Suppl 1):S78-S79. doi:10.1017/S0266462324002290.
