OBJECTIVES: This research was conducted to assess how the specialist vaccines are evaluated and the impact this has had on funding compared to more traditional vaccines METHODS: The study was conducted across the UK, France, Germany, Sweden and Japan.  An in-depth piece of secondary research was undertaken to determine the process of assessing vaccines, focusing on how the Pricing and market access was achieved by most recent vaccines entering the market. Short interviews were then conducted with a variety of key vaccine stakeholders, including payers and key opinion leaders to assess how more specialist vaccines might be reviewed within the market, focusing on what product elements influence use and funding through a national program RESULTS: The process of assessing vaccines varies by the market and has seen some changes through political reforms, although the decision to fund nationally tends to be based on similar criteria across markets. The greatest focus for funding of traditional vaccines is the patient population and overall benefit, allowing easy inclusion into a nationally funded programmes. Several of the most recently approved vaccines, including Gardasil, have achieved a high price across markets.  Despite this stakeholders are still looking to drive down the cost of these programs through application of tenders, wherever possible, with increasing scrutiny over high cost products.  The trend for more specialist vaccines has meant that the national agencies are unable to approve use in a national program due to them not fulfilling market criteria.  Specialist vaccines are viewed as not relevant for the national vaccination programmes resulting in funding through more standard drug pathways and potentially non reimbursement in markets where this is not possible. CONCLUSIONS: A standard vaccine pricing strategy cannot be adopted for specialist vaccines as this is not relevant in most cases and in some instances patient willingness to pay needs to be considered