OBJECTIVES: Our objective was to analyze the French HTA decision making process of the Transparency Commission (TC) and try to identify unwritten decision rules which influence a drug’s SMR and ASMR. METHODS: We analyzed the TC database for the years 2005 to 2010, looking at key points of the TC’s opinions listed within such as: SMR, ASMR, target population, public health impact, presence of alternatives, orphan drug status, prescription restriction etc. Using a bivariate analysis we compared drugs granted: insufficient SMR versus other SMR; ASMR V versus ASMR IV; ASMR IV versus ASMR I, II and III. RESULTS: We found that drugs granted an ASMR V more often had alternatives than drugs with an ASMR IV (89.74% vs. 69.82%, p<0.005), while prescription of drugs with an ASMR IV was more often restricted than for drugs with an ASMR V (p=0.01 for hospital-only prescription and p<0.005 for specialist prescription). The median target population for drugs with an ASMR IV was also smaller than for an ASMR V (15,000 vs. 97,250). On the other hand drugs with an ASMR IV more often had no public health impact than those with an ASMR I-III (55.70% vs. 22.13%, p<0.005). Drugs with a high ASMR had smaller median target population (3,400 vs. 15,000) although there was no difference in orphan drug status between the two groups (9.47% for ASMR IV vs. 14.07% for ASMR I-III, p=0.20). More drugs with ASMR I-III were paediatric medicines (30.04% vs. 14.79%, p<0.005). CONCLUSIONS: Further analyses are in progress using additional qualitative criteria extracted  from the TC’s opinions and using a multivariate analysis. Such information would be critical for the development of TC application dossier.