Table 2.

Elements in Costa Rica’s priority-setting legal instruments

Transparency	Transparency is one of the principles that regulate the CCP, as established in article 5 of the committee’s regulations.41 The priority-setting process and the way in which decision makers are chosen are described in the CCP’s regulations and in the Official Medicines List; these legal instruments are made publicly available on the websites of the CCSS and the Attorney General’s Office. Justifications for decisions must comply with the requirements established in article 11 of the Official Medicines List’s regulations.42 The Official Medicines List is revised and edited every two years.43 The modifications are published in the CCP’s bulletin, which can be found on the CCSS’s website.44
Relevance	Only health professionals may participate in the priority-setting process; however, article 6 of the CCSS’s health insurance bylaws establishes health councils for promoting citizen participation in health centers.45 The decisions have scientific and epidemiological justifications since some of the criteria for decision making are clinical effectiveness, epidemiological data, and economic and pharmacological studies.46 In addition, the national medication policy must be guided by the principles of universality, equity, and solidarity.47
Review and revision	The Official Medicines List is revised every two years.48 Article 21 of the CCP’s bylaws establish a process for decisions to be questioned by persons who have a legitimate interest in the issue; these requests must be filed no more than five days after the decision has been made.49
Oversight and supervision	There is no mention of how oversight and supervision activities should be conducted.