In recent years, there has been a proliferation of guidance, demonstration projects, and use cases involving the use of real-world evidence (RWE) to inform regulatory, payer, and health technology assessment (HTA) decisions, but what have we learned? This session will provide a balanced overview of recent successes and challenges for HTA Experts will showcase success stories where RWE has been pivotal in assessing value for reimbursement decisions. This will be followed by an exploration of ongoing challenges, including transportability of evidence across jurisdictions, data quality concerns, and methodological hurdles that limited the use of RWE in HTA decision-making.