Objectives The objective of the study was to provide an external assessment of recent HTA institutionalization in Brazil, and identify a set of lessons learned potentially applicable to BRICS States Methods This research is based on a quantitative and qualitative assessment. A literature survey between 2000 and 2014 was conducted in English, Spanish and Portuguese in PubMed/Medline, Science Direct, LILACS and SciELO. Epidemiological and socio-economic data was retrieved from national health accounts as well as WHO/PAHO, OECD and World Bank. For the Brazilian National Committee for Incorporation of Technologies (CONITEC), available reports on the incorporation of medicines into the National Unified System (SUS) for the first two years of operation (2012 and 2013) were analyzed. A matrix containing quantitative and qualitative criteria was elaborated to analyze reports by the outcome of decision, therapeutic class, author (s) of the request and public consultation. Results A total of 92 available CONITEC reports for 2012 (n=38,33 for medicines) and 2013 (n=54,42 for medicines) were analyzed. 45 % of reports on medicines recommended incorporation into the SUS. Most of the positive recommendations were clearly related to public health priorities as identified by the government, translating a strong commitment for improved access to medicines within the SUS i. e. anti-cancer drugs. Overall, the creation of the CONITEC represents a substantial step toward the institutionalization of HTA, with more transparency and accountability in decision-making processes, considering ethical, organizational, social, and legal aspects. Conclusions Whereas lowest in Russia, India and South Africa, and at a transitional stage in China, Brazil has a comparable degree of institutionalization of HTA as countries with a long-lasting HTA experience. A best-practice assessment in the area of HTA within the BRICS has still to be elaborated. Transferability of lessons learned might be a strong tool for improving HTA development within the BRICS.