OBJECTIVES This study aims to determine if the recently proposed model for therapeutic positioning reports (IPTs) in Spain is actually being used as a supportive tool for pharmaceutical pricing and reimbursement (P&R) decisions whilst delivering greater transparency and regional market access harmonisation. METHODS Primary research was conducted with regional payers on the proposed model of IPTs, which contain a comparative evaluation on effectiveness and safety, as well as criteria of use, for newly authorized medicines and older medicines which have a high potential health or economic impact. This was supplemented by secondary research. RESULTS The publication of IPTs has brought quicker uptake and greater homogenization to the market access of certain medicines. Notably, according to primary research, protease inhibitors were made available in all autonomous communities (CCAAs) two months after the IPT publication. However, the deadline of 3 months for the publication of IPTs is generally not being met.  As delineated in the model and shown by primary research, IPTs are starting to be used as a basis for P&R decision-making in Spain and play an important role in the identification of the most suitable target patient population. IPTs are also delivering on promises of generating consensus amongst the Spanish CCAAs.    CONCLUSIONS IPTs are being used to support the Inter-ministerial Commission of Medicine Prices and the Directorate General of Pharmacy and Basic Services role in P&R. If accepted by the majority of the CCAAs, IPTs will also serve as a tool to evaluate and limit discrepancies in innovative medicines access throughout Spain. However, there is lack of consensus of whether an IPT should include an economic evaluation from the start. Contrary to manufacturers, regional payers generally believe its inclusion would help with the selection of more cost-effective medicines whilst aiding with the adoption of IPTs in general.