ISSUE: Health Technology Assessment (HTA) on a trial basis has been introduced in Japan in 2016. The intention is to use cost-effectiveness results as a tool for price revision of selected listed products (not for initial reimbursement listing) with huge budget impact; more specifically, to use it as a tool for adjustment of premium portion (not the whole price) of the price which was granted at initial launch. This session is to bring the key observations and learning from the trial HTA phase in Japan from industry, academia and government perspectives, and to discuss potential future directions and collaboration opportunities among key stakeholders in HTA implementation in Japan. OVERVIEW: Japan is about to introduce “unique” HTA system at least in the pilot phase, under which ICER values are directly reflected to the price revision rate, while would not affect coverage status. Then, it would be good to discuss if this tool is the best tool to serve the purpose. Japan has a sophisticated pricing system to determine pricing at initial listing as well as pricing over life cycle management with re-pricing mechanisms, with additional re-pricing mechanisms after 2018 pricing reforms. Seven pharmaceutical products were selected for the trial HTA program based on their market size and premium granted at initial launch. Their HTA review and results implementation was supposed to be implemented in April 2018, however, it was postponed to April 2019 to have more time to reconcile the assumptions used in the analysis, discrepancy between two results from manufactures and external review groups, etc. Each panel can share their observation and learning from the trial program, e.g. process, and have constructive discussion on the next steps to have more orchestrated and efficient approach to serve the shared goal of sustainability in healthcare budget.