OBJECTIVES: To determine whether stakeholders’ opinions on market access issues, in particular the need for QALYs, and risk-sharing, differ by sector and geographical location. METHODS: A self-completion questionnaire was presented to a cross section of delegates at the 13th European ISPOR Conference 2010. The questionnaire comprised 7 items, with both ordinal-polytomous Likert scales and open ended responses. Analyses were performed to discriminate between the stakeholder groups including Pearson Chi-squared test of independence, cross-tabulations, and other descriptive statistics for nominal categorical data. The level of agreement between responder groups was obtained from Cohen’s Kappa coefficients and radar plots. RESULTS: Respondents included representatives of over 60 companies and organisations from over 30 countries. Highly significantly different responses were observed between members from European and non-European countries, with the greatest overall level of agreement being between the industry and academic sectors (87.5%, K=0.75). Fewer respondents from European countries favoured the use of the QALY than those from non-European countries (31.8% vs. 69.2%), whilst significantly more academics favoured the QALY than either industry or agency respondents (62.1% vs 36.6% vs. 21.4% respectively). More academics felt that manufacturers should offer patient access schemes (PAS) routinely (41.4% vs. 19.4% vs. 14.3%). Of non-European respondents, 50.0% felt risk sharing should form part of all health technology assessments compared with only 25% of respondents from European countries. The majority of non-European respondents (53.8%) expressed the need for manufacturers to provide PAS routinely; only 16.3% of European respondents agreed. Only 13.3% of respondents from European countries thought indirect comparisons are a substitute for head-to-head trials, compared with 38.5% of respondents from non-European countries. No other significant differences in opinions on the need for cost-utility analysis or cost-per-QALY thresholds were found. CONCLUSIONS: Opinions on market access related issues differ significantly between European and non-European ISPOR members, and between stakeholder groups.