Many Arabic countries are currently facing economic and financial difficulties. The increasing cost of oncology drugs is a major problem for payers and health care systems in the region. Balancing access to innovative oncology drugs with existing budget constraints in many health care systems represents a major challenge for decision-makers in the Arabic region. There is a need for applying stringent regulations to ensure the cost effectiveness of oncology drugs and to improve access to innovative oncology drugs in the Arabic region. This forum will shed light on the experience of addressing these challenges in different countries and will discuss future decision making strategies to achieve efficiency and improve access to oncology drugs for cancer patients in the Arabic countries.