OBJECTIVES: Cancer outcomes in the United Kingdom are inferior to those in France, which may be attributable to less effective screening, later diagnoses and longer waiting times.  But access to state-of-the-art medicines may also be a factor.  This poster aims to compare access to orphan oncology drugs in France, where the HTA evaluation is based on clinical effectiveness, and the UK, which employs a cost-effectiveness approach.  METHODS: We identified a total of 33 EMA-approved orphan oncology indications. To ensure a homogeneous sample, we excluded all those targeting non-therapeutic indications, as well as those not reviewed by France’s Transparency Commission (TC), the National Institute for Health and Clinical Excellence (NICE) in England and Wales, and the Scottish Medicines Consortium (SMC).  This left a total of 24 orphan indications.  To determine a relationship in the outcomes of the Health Technology Assessments (HTAs) in France and the United Kingdom, we developed a scoring system based on the ASMR rating awarded by the TC in France and the recommendations provided by NICE and/or the SMC in the United Kingdom.  RESULTS: Although prices are similar, access to orphan oncology drugs is far greater in France than the UK.  Of the 24 indications in our sample, NICE recommended just five for the NHS in England and Wales (an additional two were made available through the Cancer Drug Fund).  In Scotland, the SMC recommended seven of them, but only two for unrestricted use.  By contrast, 23 out of the 24 indications are reimbursed in France.  Regression analysis on the HTA outcomes scores revealed no relationship between the ASMR scores awarded and the verdicts from NICE and/or the SMC (r2 = 0.002). CONCLUSIONS: In its proposed transition to value-based pricing, the UK Government has the opportunity to revise its HTA process to make innovative cancer drugs available to more patients.