Objective: Digital technologies are increasingly affecting data availability, evidence assessment and disease management within the health sector, resulting in new definitions of value. This study aims to explore how digital technologies affect the perception and influence of patients and physicians [Adopters] on the evidence value assessment and decision-making processes of HTAs and payers [Decision-makers] in Europe. Methods: A targeted literature review and a multi-stakeholder survey was administered to physicians, patients, national and regional payers and HTA experts, [n=80] in five European markets [EU5]: UK, Germany, Spain, Italy and France. The survey assessed the extent to which digital technologies influenced payers and HTA agencies in their perception towards evidence needs, decision criteria; and patients and physicians in terms of their engagement with the HTA process. A cross-country comparison was undertaken to identify dominant themes and explore local specificities. Results: Our analysis identified key areas of real-world evidence where digital technologies are enabling patients and physicians to make a significant impact on HTA and payer decision-making. A heat map analysis based on survey responses suggests the scale and speed at which digital technologies are making this happen across each market. Conclusion: Our findings suggest that digital technology is increasing the influence of physicians and patients in HTA/payer decision-making, ongoing value assessment through real world evidence and phase four studies. Although most markets are advancing rapidly on their digital health implementation agenda, both physician and patient-reported health data through digital technologies are yet to be streamlined as key inputs for technology appraisal. In future, digital technology, empowered patients and physicians will result in a more comprehensive and continuous (real-time) evidence base informing disease management, HTA, and market access decisions.