OBJECTIVES:  This poster examines the pharmaceutical price implication for rare disease products in two countries which recently developed technology assessment and pricing processes with a look toward the potential implications for the United States.  METHODS: Case studies are built out of examining prices for the Multiple Sclerosis drugs interferon beta-1a and natalizumab in the context of Brazil, while the Gaucher’s disease products imiglucerase and miglustat are studied in Canada.  In each case, a brief overview of the health systems is given, with specific attention to the pricing bodies.  The prices for drugs which came to market before and after the advent of a pricing body are compared relative to each other. These differences are then compared to the price differential in the US and UK to determine if the HTA body was instrumental in this pricing change.  RESULTS: In Canada miglustat is 17.8% of the cost for imiglucerase while in the US it is 38%, with a similar trend in the price of MS drugs in Brazil.  To some degree, the lower price is expected as the drug classes are different. However, the disparity between a 17.8% differential and a 38% differential suggests that the Canadian pricing body is used to apply downward pressure on the price of rare disease drugs.  CONCLUSIONS: The price differential has distinct implications for the US market, in which payers may look towards developing a technology assessment process using cost effectiveness research to drive down costs due to the current environment.  As one of the most important markets for pharmaceutical profits, this has considerable ramifications for industry in terms of income and innovation incentive.