OBJECTIVES: Brazil & China represent two fast growing markets for oncology products. Market access drivers for new oncology brands are not transparent. While manufacturers are increasingly pursuing patient access schemes to drive market access in developed markets, it is unclear if these will be as applicable in these emerging markets. METHODS: A total of 15 payers, payer advisers & price-sensitive customers across both public & private sectors in Brazil & China were interviewed in late 2009 to understand their evidence requirements for new oncology products, and their openness to flexible pricing agreements or patient access schemes RESULTS: The primary market for oncology brands in China remains the self-pay hospital market, for which critical market access drivers are compelling local efficacy data, the perceived revenue opportunity for the dispensing hospital and KOL endorsement. While discounts are a vital market access driver at this level, at national level price-volume agreements for high-cost oncology brands are being considered for the first time as a criterion for access to the National Reimbursement Drug List (NRDL), under a pilot negotiation scheme. Economic arguments, based on local data, are also becoming more important for reimbursement. In Brazil, public payers are most concerned with cost-effectiveness, while private payers consider clinical benefit the most important factor in decision-making. There are no flexible pricing arrangements for oncology products in Brazil, but both public & private payers express interest in discounts based on the duration of treatment. CONCLUSIONS: Outcomes-based agreements are inappropriate for either the Brazilian or Chinese setting due to difficulty in implementation and monitoring. However, price-volume deals will be considered, in Brazil in the private sector and in China in the public sector. Further development of public PE requirements is anticipated in light of recent policy guidance on NRDL revision processes & NICE consultancy to the Health Ministry.