OBJECTIVES: The assessment and decision rules for the new treatments based on precision medicine (precision oncology) should be much more complemented with health economics aspects. The aim of our study was to suggest a value assessment framework for the evaluation in precision oncology in Hungary. METHODS: After the review of relevant publications (systematic literature review from the last 5 years) on health economics aspects and value based evaluation of precision medicine a wide range of uncertainty parameters and influencing factors of cost effectiveness were determined. Based on the recommendations, the identified factors and the local features a decision tree-based cost-effectiveness model structure was developed. RESULTS: The decision support economic modelling includes a lot of uncertain parameters (selection of patients, suitable treatments, real word efficacy etc.) and as a result the real value, the real cost-effectiveness of precision treatment are difficult to evaluate and pose challenges to the payer. Because of this reducing uncertainty is necessary in a special way. As in the cases of managed entry agreement and conditional reimbursement, the implementation of precision medicine to the healthcare practice should be achieved just under suitable risk-sharing agreements. Furthermore, the real word data and outcomes also should be collected in a properly controlled and structured database for permanent reassessment and to build those into the cost-effectiveness model in aim to determine the expected cost-effectiveness. CONCLUSIONS: The value assessment framework with use of collected real word data are necessary to the determination of expected cost effectiveness of precision decisions, based on the conditional reimbursement frameworks which are applied in many European countries.