There is limited access to targeted therapies for renal cancer in many parts of the western world. This is driven by reimbursement rather than regulatory issues. Indeed, only a small fraction of the global population benefits from unlimited reimbursement of targeted therapies. Dedicated bodies, such as the UK National Institute for Clinical Excellence, assess agents on their cost-effectiveness as well as their efficacy. The results have been disappointing for patients, with the majority of agents being rejected for reimbursement. Despite this trend, there is a general appetite to address cost and value in many part of the world. This article gives a current overview of this rapidly changing field.
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