Combination therapies are a mainstay in cancer treatment, but reimbursement access can be limited, owing to complexities around value assessment and pricing, and budget impact. Traditional frameworks for value assessment lack specific methodologies for evaluating combinations. A key challenge is value attribution between components. Here we provide the authors’ perspectives on this challenge, along with a summary of current market approaches and two proposed value attribution frameworks (VAFs), including their limitations and what would be needed to apply them in practice.