OBJECTIVES: Collaboration between pharmaceutical companies and Companion Diagnostics manufacturers (CDx) lead to improved understanding of the pharmaco economic needs of payers which lead to an improved quality of life for patients. METHODS: The last 5 years of EMA approvals were scanned to identify types of collaborations and their impact on patients in terms of QALYs and access in the EU markets. Different types of collaborations were categorised and compared against the patient groups that benefit the most. The impact in terms of the patient quality of life and future population costs were considered. RESULTS: Different levels of benefits in patients depending on the types of collaboration between CDx and pharmaceutical companies were identified. In particular, the assessment of the collaboration across various stages of drug development showed that the earlier the collaboration, the more compelling the patient outcomes are directly leading to improved access and quality of life for patients. An examination of the nature of the collaboration between pharmaceutical companies and CDx suggested that early collaboration was particularly successful because it enabled both parties to become aware of HTA hurdles and overcome them by developing an appropriate strategy. CONCLUSIONS: Collaboration with pharmaceutical companies is vital for CDx companies, while it is also very beneficial for pharmaceutical companies that are not keen to divert resources towards developing CDx. By collaborating early with manufacturers, CDx subpopulations can be better identified which leads to an improved quality of life for patients.