This work project develops a case study distilled from the assessment of the current environment in the pharmaceutical industry, of its trends, drivers and geographies. A pharmaceutical company and a national health authority conduct price and reimbursement negotiations upon market access. The case focuses on the possibility of value creation through the development of package deals and contingent contract clauses in a situation where, if only a single-issue and value claiming agenda is pursued, the zone of potential agreement is non existent. The case also reflects upon the management of the negotiation process, and how to manage different expectations