There is an explosion in availability and utilization of next generation testing (NGT) approaches that include multiple genes/genomic biomarkers and require novel value demonstration strategies. NGT approaches include those covering an array of diseases areas and many such tests cover multiple indications in a single assay. Substantial data is being generated through routine clinical NGT use, and potentially available for evaluating real-world clinical utility in health technology assessment (HTA) decision-making. This forum based on a collaborative project of the Medical Devices & Diagnostics and Precision Medicine SIGs aims to outline and debate the following: Key differences between NGT approaches and more ‘traditional’ diagnostics; How these differences challenge NGT value demonstration and HTA; Addressing challenges with clinical and economic value demonstration from the NGT developer/ manufacturer perspective; The critical role of NGT in progress towards health system-wide precision medicine, and related policy issues; NGT assessment challenges from the HTA perspective.