OBJECTIVES: Innovation in healthcare has become increasingly expensive making it difficult for pharmaceutical companies (PHARMAS) to have their products reimbursed. The Brazilian context is even more complex due to the current economic crisis, complex incorporation pathway in the private market and accelerated growth of the generics market. Thus, most PHARMAS are strategically investing in the Public and Private Healthcare Market Access (MA) area. We aimed to analyze whether pharma professionals (PP) in Market Access understand the importance, challenges and requirements of this new area. METHODS: We conducted a survey with PP (sales, marketing, medical affairs, market access) from various PHARMAS in 2014, consisting of a questionnaire with open questions about the definition of market access and challenges or doubts about the topic.  RESULTS: A total of 136 professionals from 6 different multinational PHARMAS answered the survey. We observed a great dissonance about their definition of market access. Most responders believed MA should focus on patients’ access, not just to drugs, but also to procedures and hospitalizations. About 75% (n = 102) stated concerns and obstacles to MA success. The majority focused on asking how to obtain specific product incorporation, and which were the pathways and criteria for technology incorporation in both public and private Brazilian healthcare systems. Most reported difficulties are the lack of integration between MA and other areas in the company, dissonance of objectives and points-of-view among healthcare players and the lack of qualified professionals in Brazil. CONCLUSIONS: There was a great disparity in the definitions of what is market access, most likely due to the relatively recent interest in the area in Brazil. Also,  many PP still do not have enough training to build a successful MA strategy, besides lacking the necessary integration with other areas to achieve their objectives.