OBJECTIVES: Most oncology drugs have development plans that includes multiple indications and often the value they bring in some indications can be higher than others.This study aimed to understand what the best pricing strategy would be when a drug’s value is different across indications and how payer willingness to pay may be impacted when the time between the regulatory approval of the indications takes 1 year or more. METHODS: In-depth secondary research was conducted on 18 oncology drugs that were launched in 2 indications or more This was followed by 1-1 interviews with senior clinicians, policy makers and national and regional payers in EU5. RESULTS: Observation of price changes indicated differences in response by market. The key difference was observed in net prices. Factors such as the unmet need in different populations, the magnitude of efficacy (primarily OS and PFS), the size of the population, the time difference between launches were determined to be key decision drivers influencing the price and access of oncology drugs. Although payer concerns were more related to clinical benefit and budget impact, they were also vary of deliberate delaying tactics by pharma in manipulating launch sequence to influence price. The analysis revealed that in order to ensure the price of one indication is not impacted by that of a follow-on indication, a minimum of 18 months between indications is expected. CONCLUSIONS: Even though delaying a drug’s initial launch in one indication to obtain a higher price for another may appear to be an attractive strategy, research shows that drugs that employed this strategy have often resulted in a lower price than what they might have achieved by pursuing ‘natural’ launch sequence. Companies developing drugs in oncology should aim to come to market upon initial approval to maximise revenue and avoid conflicts with regulatory authorities, clinicians and patient groups.