OBJECTIVES: The variation in health system regimes creates cross-country differences in prices for the same pharmaceutical product. Additionally, the price of an innovative drug (Pi) is generally dependent on the cost of the reference treatment (R), and the added value relative to the reference treatment. Pi = R+ D. Then the objective of this study is in threefold:

• First to the assess trends in prices of anticancer drugs in different OECD countries.
• Second to examine the impact of the specifics regulations in the pricing.
• Third to examine the effect of the value added of the innovative anticancer drugs in the pricing.

METHODS: We investigate both the impact of the add value and the regulation in the pricing of the anticancer drugs. To do so, we estimate a country fixed effects model: Y_i,j= a + B_,j + E_i,j with (i,j =1…n) Where Y_i,j is a price for a drug i in a country j. X_i,j is the vector of drugs characteristics, and B_,jis the country fixed effects. RESULTS: A total of 207 drugs prices were observed across all countries in the study. Our model evaluated the impact of twelve variables considered most likely to impact the prices setting. The model fitted the data well (R=55%). As expected the therapeutic added value had a significant effect on the prices, with one month of Progression free survival gained increasing the Prices with 80 € (p<0,001). For the clinical evidence, the design of clinical trial shows a coefficient of 510 € (p<0,001). The form and the drug age has a significant impact on the prices. The fixed effect demonstrates that the level of pricing disparities reflects the differences in the pricing regulations CONCLUSIONS: This study demonstrates that the level of pricing disparities, in most cases reflect the therapeutic added value and the differences in the prices mechanisms.