Gene therapy, ATMPs (advanced therapy medicinal products), or personalized medicine—all these buzz words are now part of the day-to-day reality in our industry. With several recent regulatory approvals across the globe, discussion has ensued in earnest on how to assess their value and whether traditional reimbursement systems and health economic methods are fit-for-purpose to meet the unique challenges being encountered. These challenges center less on whether the innovations provide value, and more on affordability in our current short-term global financing systems. To date, manufacturers have proactively addressed these topics with payers in various markets through pay-for-performance arrangements, milestone payments over various durations, and other novel payment schemes. All these developments over the short- and mid-term will lead to significant changes in how health care systems assess innovations during Health Technology Assessment pathways. Further, they will impact how financing systems evolve, especially with respect to risk sharing on potential outcomes. This symposium aims to provide insights on how payers and manufacturers across a number of important markets are currently dealing with these challenges.