OBJECTIVES: We aim to define and develop risk - and more specifically market access risk – as a framework towards understanding and evaluating stability in market access systems at an individual country level. METHODS: We created a combination model of rating quantitative and qualitative variables which affect a country’s ability and willingness to pay for new drugs. The criterion for selection of variables is based on relevance, availability and uniformity in our model.  We included a total of 42 variables categorised under three verticals - quantitative, qualitative and measures of stability. In order to derive a non-recursive model of ratings, we fit the regression equation for quantitative and qualitative variables as: Y(1) = αi + ∑βi*Xi + ε (Equation 1.1) Y(2) = αj + ∑βj*Xj + ε (Equation 1.2) where Y(1) and Y(2) are  the market access risk ratings for quantitative and qualitative variables, Xi and Xj are vectors of independent quantitative and qualitative variables, and ε is the error term. The final score was derived by taking the geometric mean of the two ratings together with ratings for the measures of stability and is described as below: Total Risk Score = √Y(1)^2* Weight of Y(1) + Y(2)^2*Weight of Y(2) + Risk Rating (Measures of Stability)^2*Weight of (Measures of Stability) RESULTS: We decided to aggregate risk scores from different countries into defined clusters – such as BRICS (Brazil, Russia, India, China and South Africa), BRICS-MT (Brazil, Russia, India, China, South Africa, Mexico and Turkey), and Emerging Europe (Czech Republic, Hungary and Poland) - for easier comparison. Their respective risk scores were 4.17, 4.96 and 3.30. CONCLUSIONS: Market Access Risk ratings could serve as a starting point for crafting tailored strategies to fully capitalise new opportunities. These ratings could also serve as a benchmark for a country to improve its overall access to pharmaceutical products and improve quality of care.