Gene therapy offer patients the promise of improved health, longevity, and hope. However, the infancy of the technology and its sizable impact on budget conscious payers raises fundamental questions regarding gene therapy’s value. This column addresses the challenges associated with its value assessment and suggests initiatives which may help address these issues. Given payers’ reliance on value assessments to decide whether to provide access to these technologies and innovators’ reliance on such assessments to set prices, further analytic research in this direction is essential.