OBJECTIVES: Manufacturers underestimate the time till reimbursement in the US for dermatology products and procedures.  The purpose of this study was to examine the factors influencing time to reimbursement for different products and procedures and to identify strategies for ensuring optimal reimbursement status and CPT code valuation for such products, including consideration of the appropriate distribution channel. METHODS: The study involved 25 interviews with commercial medical and pharmacy directors, specialty pharmacy distributors, dermatologists and dermatology office managers.   Interviews focussed on the perceptions and experiences of the interviewees in the prescribing of, and reimbursement for, new dermatology products and procedures.  An analysis of historical coding evaluations for dermatological procedures was conducted and the challenges in building a valuation that is commercially viable were identified.  RESULTS: Interviewees had multiple experiences of lacking the appropriate codes to secure reimbursement for the use of new dermatology products and procedures.  These experiences have resulted in a situation where initial uptake of new products is out of line with the expectations of manufacturers.  The process for informing the valuation of codes was considered to be highly politicised, with a need for extensive investment in supporting the case for the relative value units of a procedure.  “Buy and bill” distribution routes were considered to be unsatisfactory from the point of view of dermatologist offices based. CONCLUSIONS: Manufacturers of new dermatology products that require the use of a procedure need to carefully consider their strategy for ensuring a reimbursement status and distribution route that enables dermatology offices to be reassured in using their product.  A lack of planning may result in a total lack of uptake even for products that are of recognised clinical benefit.