OBJECTIVES: The increasing inability of healthcare systems to afford high cost drugs is a common focus across countries. This study aims to identify country specific healthcare policy, drug evaluation and pricing trends that may impact the commercial opportunity of future high cost treatments entering the market in the next 3-5 years. METHODS: Secondary research was performed to identify current changes/trends around healthcare policy, drug evaluations and pricing in all scope markets. Areas of focus were oncology, haemophilia and orphan drugs. Sources included peer-reviewed publications, news websites, analyst reports, congress/conference abstracts and country-specific news, policy, governmental and healthcare websites. Only references published in the last 5 years were included. Trends were extracted and collated. A focus group approach was used to evaluate which trends may have an impact on the commercial opportunity for new treatments. To ensure robustness, respondents were required to have at least 10+ years of experience in pharmaceutical commercial & market access strategy. RESULTS: Several important country-specific trends that manufacturers should monitor over the next 3-5 years in terms of their direct & indirect impact on commercial opportunity for new treatments were identified. For example, in the USA, the potential merging of national insurance plans could directly decrease manufacturer negotiation power where the publication of the American Society of Clinical Oncology value framework may have an indirect impact on payers’ willingness to negotiate on price/access. In Brazil, the increasing implementation of Partnerships for Product Development programmes will have a direct impact on access for new treatments where the evolution of the economic crisis will have a more indirect impact. For each country, trends around healthcare policy, drug evaluations and pricing were identified. CONCLUSIONS: In addition to the global trend of affordability concerns, several country specific trends were identified that manufacturers should monitor in terms of impact on commercial strategy for new launches.