ISSUE: How can health systems with different levels of funding determine a new technology’s value whilst taking into consideration its affordability and the needs of all patients? How do manufacturers plan their research and development given international variation in available resources, value assessment, systems’ ability to achieve agreed volumes and international reference pricing? Sculpher will moderate and set out the challenges faced by health systems and manufacturers and the range of solutions advocated for valuing innovation. Claxton will propose the use of an evidence-based assessment of the benefits offered by technologies against relevant opportunity costs, and the use of rebate schemes to reflect the differences between international list prices and affordable value-based prices. Goldman will provide a critique of conventional methods of HTA and their failure to reflect the full value of innovations. Grueger will set out an industry perspective and the need for predictable signals of value. OVERVIEW: Health care systems internationally face the common problem of determining which new medical technologies should be funded from available resources. All decision-making bodies seek to balance the needs of potential recipients of new innovations with those of others who could benefit from different interventions delivered from the same funding. Many attempt to use HTA as a means of securing appropriate evidence to inform decisions and to reflect these considerations. What types of evidence are needed to support these decisions, and what is missing from standard HTA? To inform development decisions, technology manufacturers need clear signals regarding how health systems value new innovations and the volumes they will purchase over time. How can those signals be revealed given international variation in health system funding, different approaches to value assessment and the challenges faced in setting different prices for each jurisdiction?