OBJECTIVES: To compare the factors leading to favorable and unfavorable recommendations for advanced non-small cell lung cancer therapies across six HTA bodies. METHODS: We evaluated HTA reports published by NICE, SMC, IQWiG, HAS, PBAC and pCODR on non‑small cell lung cancer therapies to identify final decisions and the clinical and economic factors influencing these decisions. The decisions were classified as either positive or negative and to analyze the factors affecting decisions, recommendation summaries of HTA reports were assessed. RESULTS: A total of 25 HTA reports published between January 2016 and January 2017 were identified among which the decisions were positive for 68% submissions. Highest percentage of positive decisions were provided by SMC (100%) and pCODR (100%). But in pCODR, all being conditional on cost-effectiveness improvement to an acceptable level. Major factors driving positive decisions were overall survival (OS) and added clinical benefit for IQWiG, pCODR and HAS; and cost-effectiveness versus relevant comparator(s) for NICE and SMC. Highest negative decisions were provided by PBAC (100%) followed by HAS (66.7%) and IQWiG (37.5%). The leading factors for negative decisions included high ICER values mainly due to economic modelling issues for NICE and PBAC; and no added clinical benefit for IQWiG and HAS. The chief issues of economic modelling by HTA bodies involved inappropriate extrapolation of immature OS data, improper cross-over adjustment, non-inclusion of adverse event-related disutility and costs, underestimation of utility and costs due to post-progression, overestimation of comparator drug costs, and underestimation of resource use costs. CONCLUSIONS: The current evaluations signified that supporting data on OS benefit versus relevant comparators should be considered for reimbursement submissions by pharmaceutical manufacturers. In addition, robust economic models which incorporate appropriate cost and utility values and utilize sensitivity analysis for adjusting uncertainties could be useful to attain market access approvals.