Objectives Medicines or combinations of medicines often provide different levels of clinical benefit across indications or patient sub-populations, yet in most countries, medicines can only have one reimbursed price. This can break the link between price and value, potentially leading to reduced access to medicines, and weakening manufacturer incentives to launch new indications in every market. Indication-specific pricing can address this challenge. The aim of this study was to understand (i) in which situations indication-specific pricing could improve patient access to medicines; and (ii) the feasibility of implementing this pricing solution in key healthcare systems. Methods Government websites, white papers, and peer-reviewed journals were assessed to identify situations where indication-specific pricing could improve patient access to medicines. The feasibility of implementing indication-specific pricing in each of these situations was then assessed against 9 healthcare systems, also taking into consideration legal and political frameworks. Results Indication-specific pricing could improve patient access in four key situations: (i) When products have varying clinical value across indications; (ii) When indications have different population sizes; (iii) When indications have different dosing regimens; and (iv) When products are used in combination. Healthcare systems were ranked according to feasibility of implementing indication-specific pricing, High: Switzerland (1), Scotland (2); Medium: Italy (3), Belgium (4), France (5), Spain (6), England (7); Low: Germany (8), USA (9). Conclusions Indication-specific pricing could improve patient access to medicines by allowing prices to reflect value by indication, while preserving manufacturers' incentives to innovate. Budget holders no longer risk overpaying for limited value and manufacturers are not disincentivized to commercialize indications offering incremental value over existing treatments. However, the feasibility of implementing this differs across healthcare systems. Cooperation between budget holders, government officials, and manufacturers is required to set up or leverage available data required to negotiate flexible payment agreements.