Thailand was increasingly facing budget constraints when a comprehensive package of services was
provided literally free to the whole population; therefore rationing is inevitable. ‘Good value for money’ is
among the popular criteria in priority setting as it offers a sensible basis to compare marginal benefits with the
resources spent across interventions. The majority of cost-outcome studies in Thailand were subject to bias as
they relied on low-quality evidence. The methods applied also varied greatly. This hampers comparisons
across studies. The first ever national guideline was developed by experts from different institutes to propose
the most practical ways of conducting health technology assessment on the basis of economic principles in the
Thai context. This paper also draws lessons from a transparent process involving key stakeholders in selecting
technologies to be assessed given time and resources constraints. Finally, it is hoped that these tools and
methods will be applicable for Thailand to facilitate comparisons of different studies in order to better inform
policy decisions in a transparent manner.

Keywords: Rationing, Economic evaluation, Guidelines, Health technology assessment