OBJECTIVES: Patient access schemes (PAS) are commonly used in the UK as a way to reduce a drug’s Incremental Cost Effectiveness (ICER) per Quality Adjusted Life Year (QALY) ratio and gain NICE acceptance without reducing the list price. With the advent of value based pricing (VBP) in 2014, the role of PAS is expected to change. This study examines if PAS will continue to be used in the UK after VBP is introduced and what their role is likely to be. METHODS: Stakeholders involved in the current NICE health technology assessment process were interviewed to understand how PAS use may evolve following the introduction of VBP. Secondary research was conducted of government proposals for VBP implementation, the NICE response to VBP consultation and the current usage of PAS in the UK based on NICE assessments and data from the IHS Global Insight Risk Sharing database. RESULTS: With the advent of VBP, the price of a drug should in principle reflect its value taking into account the level of uncertainty related to its efficacy. All drugs that pass the VBP test should, in theory, be reimbursable, thus, eliminating the need for a PAS that adjusts the cost of treatment allowing it to meet the UK’s ICER per QALY threshold. Contrary to these expectations, primary research indicates that PAS would continue to be used as payers attempt to secure a price lower than the NICE-set VBP. CONCLUSIONS: PAS would remain a fact of life in the UK even after VBP is implemented. This would apply not only for older drugs launched before VBP, but also for new drugs and new indications marketed post-2013 because payers are expected to see the NICE-established VBP as a recommended maximum price and attempt to negotiate that down through a PAS.