ISSUE: Although momentum is building in the development of US value frameworks, it remains uncertain how these frameworks will integrate the unique factors of the US healthcare system. US value frameworks target three levels of stakeholders: health system (ICER, ISPOR, Second Panel on Cost-Effectiveness Analysis), payers/pricing (MSKCC Drug Abacus), and providers/patients (NCCN, ASCO). A comparative US-UK perspective exposes unique attributes of each health system and their role in the context of value framework adoption and implementation. The aim of this session is to trigger a conversation about how the underlying health system goals, such as health maximization, and constraints such as national and local laws, influence stakeholder perspectives in the use of value frameworks in the US. OVERVIEW: The moderator (Leopold) will introduce the structural differences between the US and UK health systems, focusing on the relationships between stakeholders in each, and a brief overview of existing US value frameworks. Borrowing from his experience in UK, Briggs describes the role of value frameworks in UK decision-making, specifically focusing on the goal of health maximization as a driver of their use and acceptance. He argues that in the US system, the adoption of value frameworks will not be consistent with health maximization. Gallagher will counter that the US system does have a focus on health maximization and that the fragmented US health system can successfully implement value frameworks. Using information from a survey of US payers, he argues that as a result of the fragmentation and constraints, there will be unique solutions in the implementation. Sherman will conclude the panel by imparting his experience with value frameworks as a US commercial payer focusing on innovation and value. The last 15 minutes will be allotted for questions from the audience.