To understand the decision-making drivers for oncology therapy reimbursement in Russia and Visegrád markets (the Czech Republic, Poland, Hungary and Slovakia).

The research reviewed publicly available reimbursement lists and HTA reports for 49 high-cost drugs approved by the EMA across a variety of oncology indications in five Central and Eastern European markets.

Almost a quarter of high-cost oncology products investigated (12 of 49) are not reimbursed in any of the markets analysed. Most of the non-reimbursed therapies represent either orphan (6 of 12) or recently approved products (6 of 12), demonstrating the general lack of orphan-specific policies in the region, as well as delayed access to innovative therapies. One fifth of high-cost oncology therapies (11 of 49) are exclusively reimbursed in a single analysed market; of these products, most are reimbursed in the Czech Republic as it represents the quickest time-to-access across the five markets. Relative to Visegrád markets, Russia stands at the top in terms of the number of molecules included in the federal Essential Drug List. Only about 10% of high-cost oncology therapies (6 of 49) are reimbursed in each country, all of which were approved by the EMA for their first indication from 2013-2015 and have already achieved reimbursement in major HTA markets, such as Germany and France.

The research suggests that access to high-cost, innovative oncology therapies in Russia and Visegrád markets is often characterised by delayed reimbursement decisions and more restricted use of oncology therapies compared to Western European markets. Despite the reliance on cost-effectiveness assessment to help determine reimbursement in Visegrád markets, the HTA process is often hindered by discretionary political forces at play, as well as factors such as HTA outcomes in other markets and the extent of budget impact; these factors align with the key decision drivers for pharmaceutical access in Russia.