Realizing true value in oncology care is the result of focused collaboration across all stakeholders, but most notably, physicians, payers, pharmaceutical companies, and patients. Each of these groups has a central role in defining the cost of and access to future cancer therapies. Given the increasing spend to develop effective drugs in an environment of tighter regulation yet lower profit margins, value-based medicine must now meet aggressive cost expectations as well as provide enhanced outcomes. Herein, we describe the current factors and perspectives that are shaping the value of oncology drug development now, and how these elements can be leveraged such that the new patient-oriented model can deliver real-world benefit and sustainability, as well as access, in the global marketplace. Through the innovative design of clinical studies and increased focus on health outcomes, regulators have begun to reward central stakeholders engaged in the pursuit of this new delivery model. Coupled with the evolution of de-identified “big data” sets and its use to motivate and inform the practice of value-based oncology, evidence of and expectations for accelerated progress have never been higher. We provide here some thoughts on how to get the most out of these current developments and advances.