OBJECTIVES: Value-based pricing is currently a topic of much interest, and there is wide-spread speculation as to how it will be implemented. The aim of this research was to address the question as to how reimbursement bodies will consider value-based pricing with regard to pharmaceuticals that can be used in multiple indications. Will there be separate prices, or an average price weighted by the population size of each different population? If so, then would the price have to be re-assessed each time the drug is approved for a new indication?  METHODS: The National Institute for Health and Clinical Excellence (NICE) in the UK was used as an example to identify those therapies that have been appraised for multiple indications. All NICE technology assessments for cancer treatments published since January 2005 were reviewed. Therapies used in different indications were identified and ICERs from these appraisals were extracted. RESULTS: In total, 12 different treatments were identified, spanning sixteen different indications within cancer. Of these, five (cetuximab, docetaxel, imatinib, pemetrexed and trastuzumab) had ICERs that were either side of the £30,000 per QALY threshold across different disease areas. For example, the ICERs associated with cetuximab were found to vary from £6,400 (squamous cell cancer of the head and neck) to £90,000 (colorectal cancer) per QALY. These data suggest that there may be a large discrepancy when considering value-based pricing across different cancer populations. CONCLUSIONS: Across indications, the ICERs for a single therapy were found to vary dramatically. Considering that almost half of therapies identified had ICERs either side of the £30,000 per QALY threshold, these results highlight the potential problem associated with labelling a pharmacologic treatment with a single value-based price. Therefore, a single price may not be appropriate, and alternative methods should be considered by reimbursement bodies.