OBJECTIVES: Since the introduction of the orphan drugs in Europe, it has been suggested that the general method of appraising drugs for reimbursement is not necessarily suitable for orphan drugs. The National Institute for Health and Clinical Excellence indicated that several criteria other than cost and efficacy could be considered in reimbursement decisions for orphan drugs. The aim of this study was to apply a MCDA framework that was proposed by Hughes-Wilson et al(2012) to a range of orphan drugs in different diseases to test the correlation between drug price and aggregated MCDA scores for each product. METHODS: A MCDA framework was developed using the nine criteria suggested by Hughes-Wilson et al