ISSUE: Economic assessment will often describe different incremental health gains for different uses of a drug. This may be in different indications for the same drug or in different groups of patients (e.g. high risk / low risk) for the same indication. However, most health care reimbursement models use a single reimbursement price regardless across all indications. Multi-indication drug pricing represents a potential shift in drug reimbursement practice and has been debated in policy forums in both Europe and the US. Adrian Towse will moderate and briefly present a European perspective including opinions from an OHE supported stakeholder forum. Bill Dreitlein will provide US perspective including opinions from an ICER supported stakeholder forum. Ansgar Hebborn will provide a manufacturer's point of view. Sean Karbowicz will provide a US payer's perspective.  OVERVIEW: The relative clinical benefit of a drug can vary widely between different indications or between different subpopulations within the same indication. Price and clinical value rarely match up across all indications. This contributes to tension between drug manufacturers and health care payers in the discussion about aligning reimbursement with value. Some payers view indication-specific pricing as one path to achieve value-based drug pricing. Others are resistant because of operational costs and challenges, as well as a view that this is intended to give companies more revenue rather than increase patient health. Many argue that greater volumes mean a lower overall price is needed. Manufacturers argue that differential pricing increases patient access whereas a single price may force companies to choose only the most profitable indication. Moreover lack of pricing flexibility leads to new indications not being developed. Health gain is lost. This session will debate the pros and cons of indication-specific pricing, summarizing international experience in using multi-indication pricing, and debating some of the practical challenges posed by the US marketplace.