OBJECTIVES: Whilst patient access schemes (PAS) are not a new concept, they are clearly receiving increasing attention. The first notable PAS, devised to improve access to beta interferons for multiple sclerosis, was an outcomes-based scheme designed to overcome uncertainty in long-term clinical and cost-effectiveness. It is the nature of the uncertainty that drives the design of PAS, but is there a trend towards which schemes are more popular? We analysed the design of published PAS employed in the UK in order to determine if outcomes-based or financial-based schemes predominate. METHODS: Published PAS were identified from health technology assessment websites (e.g. the National Institute for Health and Clinical Excellence and Scottish Medicines Consortium), literature searching of ISPOR conference abstracts, and searching of ‘patient access scheme’ or ‘risk sharing scheme,’ using internet search engines. PAS identified were categorised as financial-based (price- or volume-based agreements) or outcomes-based schemes. Desk research was the performed to identify the preference for each type of scheme, in terms of uptake by UK Primary Care Trusts.   RESULTS: Seventeen published PAS were identified from the literature search, from 2002 until 2010. Categorisation of PAS as financial-based versus outcomes-based showed that schemes were balanced, but favoured financial-based schemes (59% versus 41%, respectively). The uptake of financial-based schemes was found to be higher than outcomes-based schemes due to administrative burden posed by schemes which rely on the measurement and reporting of clinical outcomes.  CONCLUSIONS: PAS were pioneered by the beta interferon outcomes-based scheme for multiple sclerosis, 2002. Since then, published UK-based schemes favour price or volume-based schemes, a trend illustrated by two of the three newest schemes published in 2010. The simplicity of financial-based agreements, combined with poor health care system uptake of outcomes-based schemes and the demand for value-based pricing, suggests that this trend is set to continue.