Immune checkpoint inhibitors have entered multiple oncology indications but the high costs associated with these agents present significant challenges for payers. The potential for label expansions into additional indications and combinatorial approaches involving immune checkpoint inhibitors will put further pressure on MCO commercial plans. Developing a clear understanding of the reimbursement landscape and devising an effective market access strategy will be crucial for maximizing the commercial potential of immune checkpoint inhibitors. This content examines the current and future reimbursement dynamics for immune checkpoint inhibitors in the United States with a focus on key indications—NSCLC, malignant melanoma, renal cell carcinoma, and bladder cancer. We present an overview of the influence of payer reimbursement decisions on prescribing, and explore physician and payer opinions about emerging therapies in this drug class. In addition, we analyze future market access challenges and provide actionable recommendations for optimizing market access strategy.