OBJECTIVES: England has 152 Primary Care Trust (PCT) each having its own characteristics, and prescription patterns. As a consequence, PCT formulary lists differ, creating an additional hurdle for patient access to innovative medicines, often referred to as the post-code lottery. The objective of this study was to segment these PCTs in groups with homogeneous attitudes towards patient access for innovative drugs in Mental Health (MH) using a clustering analysis. METHODS: We collected all available information about the PCTs through public sources and the OneKey+ database. We identified 62 variables per PCT and classified them in 5 groups: profile of population, economic & financial information, organization, prescription pattern and patient management. We first ran a principal component analysis on quantitative variables and then a multiple correspondence analysis on qualitative variables, in order to get individuals coordinates of PCTs on several axes on which they were projected. We then merged the results, and ran an analysis to create PCTs clusters. RESULTS: We identified 5 clusters of PCTs with differentiated, homogeneous attitude towards innovative drugs. Cluster 1 focused on MH disorders with GP-level decision-making, cluster 2 focused on MH disorders and contained high-prescribing physicians, cluster 3 had low recognition of MH disorders, cluster 4 had low recognition but offered a high level of care while cluster 5 was focused on cost containment. The clusters also varied in population size from 1.2M to 23.9M. CONCLUSIONS: As this work was rather innovative it was validated by local pharmaceutical sales and marketing organization. The cluster approach proposed was endorsed by account managers’ pragmatic experience in the field and correlated well with their experience of obtaining access for their innovative MH drugs. This study helped to improve our understanding of the UK landscape in patient access for innovative drugs in MH.