OBJECTIVES: The recent UK value-based pricing (VBP) consultation proposes that burden of illness, therapeutic improvement/innovation and wider societal benefits are evaluated in addition to cost-effectiveness. This study explored attitudes among industry, academia and UK National Health Service (NHS) stakeholders to the proposed VBP framework, with a focus on how to define the burden of illness component. METHODS: Relevant literature was identified via a manual search to assess the use of VBP methodologies in other countries and potential burden of illness (BOI) criteria. In-depth, semi-structured 40-minute telephone interviews were then undertaken with 20 experts identified in UK academic centres, the pharmaceutical industry and the NHS. Discussions explored perspectives on VBP and in particular how to define and evaluate BOI. RESULTS: Proposed definitions for BOI varied significantly. Industry representatives wanted the flexibility to use a broad, variable set of criteria, while academic and NHS stakeholders wanted practical, consistent evaluation criteria with the emphasis on ensuring benefits are not ‘double-counted’. Stakeholder input was used to develop a framework for assessing BOI comprising disease severity, quality of life impact, treatment availability and performance of existing treatments.  Qualitative grading scales for each of the criteria were proposed. While each stakeholder group broadly endorsed VBP objectives, the research highlighted various concerns regarding its implications. In particular, the need for clear government policy and guidance, further development of acceptable evaluation methodologies (including criteria weightings), and enhanced pharmaceutical development processes to ensure evidence of sufficient quality is generated to support evaluation of product value (both at launch and over time). CONCLUSIONS: There appears to be sufficient common ground to develop a BOI assessment framework that is acceptable to both industry and NHS stakeholders. We propose a relatively simple model that could form the basis for further research and discussion, with special attention to addressing the implementation challenges.