Realistic Review (RR) is a methodology for systematic review proposed by Pawson (2002), to guide policy formulation. It is aimed at policy makers and decision makers and seeks to explain how a given intervention succeeds or fails in a certain context, allowing the identification of more suitable alternatives to solve problems. The objective of this study was to develop a theoretical model for Monitoring and Evaluation (M&E) of Health Technology Assessment (HTA) management.

The realistic review sought to identify aspects that influence HTA contributions. Studies were included if they provided a description of context and description of HTA contributions. Key purpose elements were extracted from selected studies and the contexts of HTA contributions were analyzed. The association between context and types and areas of contributions of HTA in different realities was synthesized. We analyzed thirty-one articles published in international journals in the area of health technology assessment and three articles on assessment policy in Brazil, nominated by experts.

It was possible to identify situations that generate demands for HTA; favorable and unfavorable contexts and factors for contributions; main functions of networks; main products resulting from the application of evaluations; results and impact predicted by the action of the networks.

The logical model starts with conjunctural aspects that generate demands: economic, social and cultural. In a favorable context, the definition of priorities and debates in the negotiation arenas influence research and the policy formulation process. Networks identify evidence and contribute to knowledge management, generating products, results and impacts.

The use of the theoretical model created from the realistic review is a tool that allows the M&E of HTA management.