OBJECTIVES: To explore the current status (2010) of tendering programs for outpatient pharmaceuticals in the European countries and how these programs operate. METHODS: A survey was designed to assess the features of tendering programs in European countries. All 27 countries of the European Union plus Norway were included in the study. The survey was sent to national representatives of authorities and organizations and to academic researchers with expertise in the domain. RESULTS: Nineteen of the 28 countries have responded to the questionnaire (68%). Seven countries have adopted tendering programs for pharmaceuticals in ambulatory care. Tendering was more popular in countries with a mature generic medicines market (54%) than in countries with a developing generic medicines market (12.5%). Authorities with financial interest for possible savings issued the tenders and the lowest price/best offer was amongst the criteria to award the tender in most cases. The frequency varied from only once to once every two weeks and the number of winners was between one and four. The objectives of achieving cost savings were achieved in the short term but results on long term are still unclear CONCLUSIONS: Tendering programs can achieve savings in the short term, but the effects in the long term are still unclear. It can be concluded that the policy can work, but the features of the programs such as the legal framework, the criteria to grant the tender, the number of winners, the reward of the winner and the frequency, have to be well-thought-out.