OBJECTIVES: As part of health care reform, US policymakers are debating on whether or not to create a centralized comparative effectiveness research (CER) entity to improve the efficiency, quality and long-term sustainability of healthcare.  If implemented, cancer is likely to be among the recommended primary CER topics. In Europe, there are established agencies that evaluate new pharmaceuticals to inform healthcare policy decisions (e.g., the HAS in France and NICE in the UK). This analysis will consider the strengths and weaknesses of European health technology bodies (HTA) and provide insight for the implementation of CER and how lessons learned from the UK and France might help improve efficiency and outcomes in oncology in the US.    METHODS: Secondary research will be used to review how HTA bodies evaluate oncologics and assess their impact on market access.  These countries were selected as they represent the extremes of HTA assessment in Europe.  Findings from this research will then be contrasted against current market access in the US. RESULTS: While France evaluates new products on innovation and clinical value the UK largely bases market access decisions on cost-effectiveness. Consequently, many new oncology agents available in France have been denied funding in the UK.  Meanwhile, insured Americans have relatively open access.     CONCLUSIONS: Cancer remains the second leading cause of death in the US and is a growing healthcare burden. Therefore better informed policy decisions on the efficient use of clinical services for oncology are critical. This analysis suggests that there is potential for the US to optimize on the European experiences when considering the adoption of a CER tool for oncology drugs management.  Specifically, if the US does adopt a formal CER entity, it may wish to avoid using NICE-like economic-based outcomes to change clinical practice, but and aim to play an advisory role to facilitate better informed strategic decisions (HAS-like).