A new report from No Patient Left Behind (NPLB) argues that health technology assessment (HTA) value determinations in countries such as Canada and Germany substantially underestimate the societal benefits of innovative medicines. NPLB says those methods undervalue medicines by as much as 90%, which it says can distort policy decisions and lower uptake. The group points to the way HTAs often rely on “outdated” willingness-to-pay thresholds tied to quality-adjusted life years (QALYs), and NPLB contends that such calculations miss benefits that extend beyond individual patients. It also argues the assessments do not fully capture broader economic and practical effects, including faster return to work and reduced disability payments. NPLB’s critique aligns with recent messaging from European pharma executives, including a letter to the European Union led by Sanofi and Novartis, underscoring a shared push to revise how international evaluators price innovation.