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In recent years there has been a surge in the number of new medications for the treatment of cancer. 1, 2 Many of these agents are truly innovative and transformative and their incorporation into routine practice has improved outcomes for many patients. These medications often come with a high and ever-increasing price tag, however, making it unsustainable even for the wealthiest health systems to afford all new medications and new indications for established therapies. 3-5 The rising prices of effective drugs have led to the development of the ‘Cost-Effective but Unaffordable’paradox. 6 In order to optimize the balance between improving patient outcomes and maintaining economic sustainability, 7 many health care systems implemented Health Technology Assessment (HTA) mechanisms to select which new therapies provide enough patient benefit to justify the cost of incorporating them into national insurance …