OBJECTIVES: In this study we look at two value assessment tools for cancer therapies, ESMO Magnitude of Clinical Benefit Scale (ESMO-MCBS) and American Society of Clinical Oncology (ASCO) Value Framework in Cancer, and evaluate how the two approaches differ in evaluating a cancer therapy as well as highlight important implications for practitioners. METHODS: We conducted a comparative evaluation across 74 non-curative oncology therapies in order to obtain value assessment ratings. RESULTS: Among the 74 treatments tested, the highest ASCO score produced was 64 out of 130.  In contrast, many of the same treatments when evaluated by the ESMO-MCBS received a clinical benefit grade of 4 or out of 5.  The entirety of the ASCO rating scale is rarely applied, and a rating which appears to be in the mid-range of the 130-point scale may in fact have an excellent treatment rating relative to other oncology products. A treatment is also more likely to receive a toxicity bonus under ESMO rating scale than under the ASCO framework. Of the 74 oncology assessments in the advanced cancer setting using both frameworks, 22 included some form of QoL or toxicity bonus under the ESMO-MCBS rating scale whereas only 4 included a palliation or toxicity bonus under the ASCO framework.   Neither scale is entirely predictive of the other in the analysis.  CONCLUSIONS: Assessing the value of cancer medications has taken center stage in the discussion of drugs and drug prices. ESMO and ASCO have taken steps to assess the value of oncology therapies by releasing their value assessment frameworks. However, the frameworks are not identical and there are several instances where therapies appear to be valued differently. As practitioners get more familiar with these frameworks and start to implement them, it is important to know the details of each framework and the resulting implications.