OBJECTIVES: : The aim of this analysis was to understand how fixed dose combinations (FDCs) of two components are priced in France compared to how they are priced in four European countries (Germany, Spain, Italy and United Kingdom) considering official rules and common use. METHODS: : FDCs were selected based on the following criteria: Transparency Commission evaluation between 2010 and 2018, ASMR V status granted, and both components of the FDC available and priced independently. The data collected were pooled and evaluated across three therapeutic areas: hypertension (HTA), type 2 diabetes (T2D), and respiratory diseases. The rules of FDC price setting in Europe were reviewed. Two comparisons were conducted: the average discount of FDCs compared to the sum of component prices at launch per therapeutic area and the current average price of the FDCs between each country. RESULTS: : Among the 65 FDCs evaluated by the Transparency Commission, 11 were selected according to the methodology used. The mean discount compared to the sum of FDC component prices observed in France was -10% for all therapeutic areas combined (-13% for HTA, -15% for respiratory and -6% for T2D). The current French FDC prices of all therapeutic areas varied between 53.6% and 91.4% of other countries’ FDC prices. CONCLUSIONS: : The discount data in France were evaluated against the CEPS’ FDC price setting rules (where a -5% minimum discount is expected of the FDC compared to the sum of its components). In practice, we observed an average discount of -10% in France with disparities according to the therapeutic areas considered. When comparing the average FDC prices across markets, they were the least expensive in France for all therapeutic areas. In conclusion the authorities’ expectations in terms of access to patient and price were heterogeneous depending on the country and the therapeutic area considered.