It is well known that a positive net present value (NPV) calculation on any product in development is a good indication that upon market release, the financial return will exceed the cumulative life cycle costs of research, development, market validation, market access, market release, manufacture and sales. Despite this market reality, rNPVs on projects and portfolios at the start-up stage for healthcare-focused endeavours are communicated either publicly or privately. Dr. Jonathan Dando at Echino Ltd and Maximilian Lebmeier at Athena Market Access Solutions Ltd examines how data being used in rNPV calculations may be incorrect, creating a disconnect between stakeholders with serious ramifications.