OBJECTIVES: Previous research has identified Multiple Criteria Decision Analysis (MCDA) as a potential methodology for assessing the value of drugs in Health Technology Assessment (HTA) and assist payers with resource allocation. However there is limited empirical evidence from real world. An MCDA value framework was applied in practice with a set of therapies for metastatic castrate resistant prostate cancer (mCRPC) through a series of simulation exercises with decision makers from different HTA agencies across Europe, including TLV (Sweden), AETSA (Andalusia, Spain), INAMI-RIZIV (Belgium) and AOTMiT (Poland). The interventions assessed were abiraterone, cabazitaxel and enzalutamide. METHODS: Using a multi-attribute value theory framework and published evidence, a mCRPC- value tree was constructed incorporating the values concerned as evaluation criteria. By adopting a MACBETH approach the different interventions were scored against the criteria through the development of value functions. Weights were assigned to the criteria using swing weighting, scores and weights were combined using additive aggregation and sensitivity analysis was conducted. Hypothetical priority setting decisions were made based on “value for money” grounds through the use of “cost per unit of value” by incorporating purchasing costs. All stages were informed through the participation of experts from each HTA agency at a series of workshops. RESULTS: Evaluation criteria considered spanned therapeutic impact, safety profile, innovation level and socioeconomic impact. In all countries enzalutamide was scored highest overall, followed by abiraterone and cabazitaxel. Selected criteria ranged from seven to 12 in total; criteria weights differed across countries however the therapeutic impact cluster always contributed the largest weight. CONCLUSIONS: The MCDA framework tested has a number of characteristics that can facilitate decision-making, including the systematic and explicit incorporation of trade-offs as part of model assessment and the transparency throughout all its stages. Therefore, it could potentially act as a practical value assessment and resource allocation tool.