OBJECTIVES: There is an acceleration and proliferation of new pharmaceutical innovation that is being introduced at premium prices. At the same time, payers and providers in the United States face unprecedented pressure to manage healthcare budgets and value-based decision-making is top-of-mind. A group of policy entrepreneurs have recently proposed several novel frameworks for assessing and comparing therapeutic value. This research reviews these frameworks and ways in which they are being used to manage access to new pharmaceutical innovation. METHODS: Secondary research on recently introduced value frameworks with US origin was conducted (ACA-AHA, ASCO, Drug Abacus, ICER, NCCN). Each tool was characterized based on inputs considered and key similarities/differences were summarized. Twenty five health care payers responsible for pharmacy benefit management were surveyed to assess current use of value frameworks in drug review and coverage decision-making. Respondents represented managed care organizations, pharmacy benefit management, and integrated systems. RESULTS: Existing value frameworks were found to differ with regards to consideration of: patient-centric metrics; indirect benefits; unmet need; and burden of illness. Interviewed managed care executives have increasing awareness of emerging value frameworks and a subset have begun to reference their findings in product dossiers for formulary review. Managed care faces challenges in operationalizing these tools; but several are piloting benefit designs and other programs which incentivize or reward use of therapies with superior value determinations. CONCLUSIONS: Given the current environment, healthcare stakeholders are eager for tools that inform and lend credibility to value-based decision-making. There is growing appetite to adopt emerging value frameworks by those managing access to high-cost therapeutics. For manufacturers that seek to achieve and protect patient access to pharmaceutical innovation, a clear imperative exists to ensure that evidence generation programs and messaging optimally position the product for assessment by emerging value frameworks.