OBJECTIVES: Value added medicines are defined as “medicines based on known molecules that address health care needs and deliver relevant improvements for patients, health care professionals and/or payers”. Current obstacles to their value recognition from health technology assessment (HTA) and pricing and reimbursement (P&R) perspective in Europe continue to exist creating a disincentive for further development. Study purpose was to identify key obstacles for adoption of value added medicines and elaborate on policy recommendations. METHODS: A literature review targeting health care inefficiencies related to HTA and P&R rules was completed by interviews with health care providers, patients and payers; this was followed by a focus group with representatives of pharmaceutical industry developing medicines in this field. RESULTS: Various obstacles have been identified that prevent optimal utilisation of value added medicines in terms of: 1) HTA obstacles, e.g. through existing generic medicines stigma, budget silos and current HTA framework; 2) Pricing obstacles, e.g., through pricing policies pushing price down such as internal/external reference pricing or tender/procurement policies; 3) Lack of reward for manufacturers, e.g., due to uncertainty about reward of investment to bring evidence requested by HTA bodies. This situation called for policy changes and the industry panel provided 2-level recommendations: 1) To get P&R rules that should offer the possibility for HTA pathways taking into account special characteristics of value added medicines such as enlarging scope of benefit considered in decision-making to include, for example, patients’ and health care providers’ preferences; 2) To enforce pricing policies rewarding value added medicines development such as acknowledgement of value differentiation in tenders policies. CONCLUSIONS: Current P&R rules in place in some countries prevent full recognition of value added medicines benefits and calls for policy changes to foster appropriate incentives to enhance their value recognition and encourage manufacturers from bringing such products to the market.