OBJECTIVES: The objective of this study was to analyse recent HTA decisions in Taiwan and Korea, and determine the influence on the outcome by HTA decision in Australia and the UK.    METHODS: This study examined 30 high-cost drugs that were FDA and EMA approved from 2011-2014. Two-thirds of the sample were oncology drugs, while the remaining one-third included drugs treating multiple sclerosis, chronic hepatitis C and type 2 diabetes. The HTA decisions of these products in Taiwan and Korea were analyzed as well as in their frequently referenced countries, Australia and the UK.  RESULTS: Of the 30 products studied, 24 products were assessed by PBAC in Australia and 15 products were evaluated by NICE in the UK, while only 9 products received HIRA assessments in Korea and 5 products were assessed by the CDE in Taiwan. The difference in favourable HTA outcomes among these countries was even greater. Only 2 products received positive HTA decisions in Taiwan and Korea, while 8 and 11 products were recommended in Australia and the UK respectively. Among the 8 products evaluated by HIRA, and previously assessed by PBAC and NICE, 6 products received the same decisions as PBAC and / or NICE. The correlation coefficient between HIRA and PBAC decisions was 0.75. Similarly, all 5 products assessed by the CDE received similar evaluations to those of PBAC and / or NICE, and the correlation coefficient between CDE and PBAC decisions was 1. CONCLUSIONS: Access to medicine in Asia, even in wealthy countries like Taiwan and Korea, still largely lags behind Western countries like Australia and the UK. In Taiwan and Korea, where pharmacoeconomic assessment is a key component in the HTA evaluation, HTA decisions may be greatly influenced by the HTA outcomes in countries like Australia and the UK where pharmacoeconomic evaluation is well-established.