title: Adoption of trastuzumab for breast cancer in four emerging countries in the use of health technology assessment: a case study.
abstract: To describe processes for the adoption of trastuzumab in four countries in the use of health technology assessment (HTA): Poland, Albania, Brazil and Colombia.
  
  
  
  Mixed methods were used for collection and triangulation of data. Data were examined following a conceptual framework connecting HTA process steps and key principles.
  
  
  
  Trastuzumab was generally assessed following well-structured HTA processes. Nonetheless, areas of improvement were detected in terms of transparency and inclusiveness, as well as in methods used. The extent to which different criteria influenced decisions was unclear.
  
  
  
  This study covers an area in which information may not always be available, and sets the example for emerging countries interested in HTA. Further studies to gain a better understanding on decision-making across settings are warranted.
authors.affiliation: Escuela Andaluza de Salud Pública (EASP), Campus Universitario de Cartuja, Granada, Spain.
authors.forename: Eva
authors.initials: E
authors.lastname: Martín-Ruiz
authors.affiliation: Escuela Andaluza de Salud Pública (EASP), Campus Universitario de Cartuja, Granada, Spain.|CIBER en Epidemiología y Salud Pública (CIBERESP), Spain.|Instituto de Investigación Biosanitaria ibs. Granada, Hospitales Universitarios de Granada/Universidad de Granada, Granada, Spain.
authors.forename: Jaime
authors.initials: J
authors.lastname: Espín Balbino
authors.affiliation: Pan American Health Organization (PAHO)/Organización Panamericana de la Salud (OPS), Washington, DC, USA.
authors.forename: Alexandre
authors.initials: A
authors.lastname: Lemgruber
authors.affiliation: Escuela Andaluza de Salud Pública (EASP), Campus Universitario de Cartuja, Granada, Spain.
authors.forename: Araceli
authors.initials: A
authors.lastname: Caro-Martínez
authors.affiliation: Pan American Health Organization (PAHO)/Organización Panamericana de la Salud (OPS), Washington, DC, USA.
authors.forename: Fernanda
authors.initials: F
authors.lastname: Lessa
authors.affiliation: Escuela Andaluza de Salud Pública (EASP), Campus Universitario de Cartuja, Granada, Spain.|CIBER en Epidemiología y Salud Pública (CIBERESP), Spain.|Instituto de Investigación Biosanitaria ibs. Granada, Hospitales Universitarios de Granada/Universidad de Granada, Granada, Spain.
authors.forename: Antonio
authors.initials: A
authors.lastname: Olry-de-Labry-Lima
authors.affiliation: Escuela Andaluza de Salud Pública (EASP), Campus Universitario de Cartuja, Granada, Spain.
authors.forename: Roman
authors.initials: R
authors.lastname: Pérez-Velasco
authors.affiliation: Escuela Andaluza de Salud Pública (EASP), Campus Universitario de Cartuja, Granada, Spain.|Instituto de Investigación Biosanitaria ibs. Granada, Hospitales Universitarios de Granada/Universidad de Granada, Granada, Spain.
authors.forename: Leticia
authors.initials: L
authors.lastname: García-Mochón
mesh_terms: D000074322:Antineoplastic Agents, Immunological / Q000627:therapeutic use*; D001943:Breast Neoplasms / Q000188:drug therapy*; D003657:Decision Making; D005260:Female; D006801:Humans; D011044:Poland; D013673:Technology Assessment, Biomedical; D000068878:Trastuzumab / Q000627:therapeutic use*
chemical_list: D000074322:Antineoplastic Agents, Immunological; D000068878:Trastuzumab
keywords: Latin America and the Caribbean; central, eastern and south eastern Europe; comparative effectiveness research; emerging countries; health technology assessment; oncology; trastuzumab