OBJECTIVES: Over the past years, several multiple-country joint Health Technology Assessments (HTA) and drug pricing collaborations (e.g., BeNeLuxA-I, Valletta Declaration, EUnetHTA) have been developed in the EU with the combined goal to improve efficacy, to avoid duplicity, accelerate patient access and to make use of combined negotiation power. The European Federation of Pharmaceutical Industries and Associations has recently responded to this trend by publishing new policy principles. Supplementary, our study is designed to gain understanding of the pricing and market access (P&MA) implications of existing multiple-country joint HTA and drug pricing collaborations and to categorize what manufacturer types (e.g., small, big, type of pipeline products, etc.) would be most suited for involvement in future collaborations and when. METHODS: A qualitative in-depth analysis of publicly available information was conducted to analyse the implications of the existing examples of finalized multiple-country joint HTA and drug pricing collaborations vs. country-level assessments (e.g., ASMR, NICE assessment) on P&MA. The analysis led to preliminary conclusions about the incentives of manufacturers to favour a multi-country over a country-level assessment and about the extent in which the intended goals were achieved. By evaluating the gained insights, manufacturer types were identified for whom future involvement might be interesting. Additionally, it was defined under which conditions involvement should be pursued by manufacturers. RESULTS: There is a correlation between utilization of multi-country assessments and degree of innovativeness of the submitted product; and the size of the submitting company. A number of conditions for opting towards multi-country pathways were identified along with the need for specific strategic and tactical preparations. CONCLUSIONS: This study provides insights on the pros and cons of multi-country HTA assessments and suggestions for which type of products and which types of companies these are most suited.