OBJECTIVES:  It is extremely challenging to keep up to speed with the perpetually dynamic Market access environment across different countries. This is difficult not only for pharma but for payers who have the difficult task of assessing products under tight budgetary constraints. This research is to understand the drivers influencing pricing and market access decisions.  METHODS: The research was conducted through in-depth secondary research and interviews with stakeholders in 8 countries including the UK, Japan, Canada, France, Germany, Australia, S. Korea, Sweden and The Netherlands RESULTS: Analysis indicates that the value of drugs varies by market globally due to factors of prevalence, socio-economic conditions, unmet need, disease severity, political impact and public awareness. These factors lead to differences in the perceived value of the same drug across countries making it challenging for its global launch. The research indicated that most countries, other than those that apply external price referencing use some form of value assessment to recommend the price and reimbursement. In most mature markets therapeutic gain measured through clinical advancement or cost effectiveness is the critical factor. In addition these countries consider unmet needs and disease severity as important drivers. In Sweden and the Netherlands, they consider societal perspective and Japan and Korea tend to give importance to innovation. The only value element that does not directly relate to clinical factors and is influential in setting the price is budget impact.   CONCLUSIONS: The research indicated that most countries, other than those that use international price referencing for setting prices use some form of value assessment method before fixing the reimbursement level and price of a product. It is very challenging to reward products based on their intrinsic value without considering the current economic situation. On the contrary innovation needs to be rewarded and encouraged for future R&D of new drugs.