OBJECTIVES: Health policy and funding for medications classed as ‘lifestyle’ have received considerable scrutiny by public health officials as well as politicians. This has limited public funding and reimbursement for these products in many European countries. A detailed assessment of the variation in payer coverage polices for lifestyle medications across Europe was conducted. METHODS: The top ‘lifestyle’ indications and associated medications were identified from a literature search using WHO, PubMed, and ScienceDirect.  Selection criteria for the medications included being first-to-market in the identified indication or being referenced as the only off-label treatment for the specified use. Public reimbursement databases (16) were used to analyze the health technology assessment and reimbursement decisions across European countries (14) for each lifestyle indication. Reimbursement was classified as favourable (broad/restricted but accessible) or no coverage (not funded). Where available, justifications for coverage decisions were analysed to determine the drivers of positive and negative coverage decisions. RESULTS: Lifestyle indications where products have achieved high levels of reimbursement include Dyspepsia (100%), Delaying Menstruation (91%), Restless Leg Syndrome (87%), and Alcohol Dependence (85%). Those with the worst coverage are Hair Loss (0%), Hypoactive Sexual Desire Disorder (0%), Erectile Dysfunction (13%), and Weight Loss (15%). Of the 14 countries researched, those offering the most favourable coverage environments for lifestyle treatments were: Belgium (70%), France (69%), and Austria (69%). The countries with the most limited (no available) coverage for lifestyle drug therapies were The Netherlands (13%) and Sweden (25%). Four general characteristics are associated with better access to market: Cross-Usage in Other Indications, Areas with High Societal Costs, Diseases that Affect Family Planning, and Older Therapy Areas. CONCLUSIONS: With pressure on public health resources, European payers are resistant to the allocation of funds for medications with lifestyle indications. Despite this, barriers to reimbursement vary substantially across European markets.