Tens of thousands of Brazilian and Mexican men are diagnosed with prostate cancer every year. In recent years, there have been multiple clinical advances in the field, with new therapies offering longer survival times, milder safety and tolerability profiles and improved quality of life over existing treatments. However, those achievements have come with a hefty price tag and while the new therapies have become the standard of care in the United States and Europe, Brazil’s and Mexico’s cost-constrained markets are still struggling to widely adopt them in their medical practice. The future will bring more new prostate cancer therapies, and while prescribers are eager to use emerging agents, limited budgets will restrict their uptake and, in an increasingly competitive market, only drugs that meet both clinical and economic expectations will succeed. This A&R analysis provides key insights for navigating the prostate cancer market in Brazil and Mexico, uncovering payer and prescriber expectations in each country.