OBJECTIVES: Our aim was to compare recommendations made by the pan-Canadian Oncology Drug Review (pCODR) one year after its launch to other markets. METHODS: Publically accessible recommendations were reviewed: Canada (pCODR; www.pcodr.ca), UK (National Institute for Health and Clinical Excellence (NICE), www.nice.org.uk), Sweden (Dental and Pharmaceutical Benefits Agency (TLV), www.tlv.se), and Australia (Pharmaceutical Benefits Advisory Committee (PBAC), www.pbs.gov.au). RESULTS: pCODR had four  product reviews in common with NICE, three with TLV, and five with PBAC. pCODR and NICE recommendations were most consistent; both positively recommended Votrient, Yervoy and Zelboraf.  Inconsistency was observed for Halaven (pCODR = positive; NICE = negative). Compared to TLV, consistent positive recommendations were noted for Votrient and Yervoy, while inconsistency was observed for Zelboraf (pCODR = positive; TLV = negative). pCODR and PBAC were the least consistent; Votrient (renal cell carcinoma) received a positive recommendation and Votrient (soft tissue sarcoma) received a negative recommendation from both, Afinitor, Sutent, and Yervoy received positive recommendations by pCODR and negative recommendations by PBAC.  Only two therapies were reviewed by all four groups: Votrient (renal cell carcinoma) which received a positive recommendation by all and Yervoy which received a positive recommendation by all, except PBAC. CONCLUSIONS: For products that were reviewed by pCODR and at least one other agency, the most consistency was observed with NICE. Discordance in recommendations may reflect process differences. For example, pCODR can positively recommend a product with acceptable clinical value conditional on improved cost-effectiveness. However, the degree of improvement is not reviewed with the manufacturer; instead it is negotiated with the provincial reimbursement bodies. While other agencies, such as NICE, will specify a patient access scheme with the manufacturer as part of the recommendation process. In addition, pCODR is the only oncology-specific agency in these countries.