OBJECTIVES: A survey was carried out to investigate the economical impact of a switch from the traditional Pharmaceutical Price Regulation Scheme (PPRS) system to a value-based pricing scheme (VBP), as proposed by the Office of Fair Trading (OFT). The OFT VBP system has its aim to price pharmaceuticals in line with their clinical effectiveness. METHODS: Interviews were carried out with experts from the industry, academia and the government comparing the traditional PPRS with the proposed VBP system. The interviews focused on the regulatory effectiveness, competition, launch delays, pharmaceutical pricing, risk-sharing agreements and uncertainty premium of the two systems. A systematic literature review was also carried out for all the above mentioned topics.  RESULTS: In the interviews the current PPRS system was seen as very beneficial with high transparency and stability, nevertheless lacking mechanisms promoting price competition when compared to the VBP system. The main concern with a switch to a VBP system was the risk of a global price lock-in. Since the UK is directly or indirectly influencing pricing decisions within about 25% of global pharmaceutical consumption, the industry might delay drug launch in the UK, to maintain global pricing flexibility (e.g. in the adjuvant setting). Risk sharing agreements were found to be one possible solution to maintain global price flexibility for the industry, while ensuring the NHS pays a fair price. The interviewed were unanimous about establishing an organisation separate from any political influences needs to handle the pricing decision to avoid conflicting incentives. It was suggested to offer a price premium for pharmaceuticals with well documented cost-effectiveness. A premium would incentivise the industry and reduce reimbursement decision uncertainty.  CONCLUSIONS: This survey indicates that a transparent and stable pricing process with proper risk-sharing agreements would increase the probability of a successful implementation of a VBP system in the UK.