OBJECTIVES: Rheumatoid Arthritis (RA) patients’ access to biologics differs among European countries. We aimed to explore the views of Portuguese healthcare stakeholders on key barriers limiting patients' access to biologics, areas of intervention to overcome the identified barriers (leverage points) and corresponding key initiatives.  METHODS: A qualitative research consisting of semi-structured face-to-face interviews with key stakeholders in RA framework. Thirty six people from eight groups of stakeholders were interviewed: rural and urban general practitioners (GPs), rheumatologists, hospital managers, hospital pharmacists, budget holders, representatives from rheumatology society and RA patient association. Interviews were conducted between May and June 2011. Conventional content analysis with research triangulation was used.  RESULTS: The identified key barriers were related with accessibility to primary healthcare, difficulties in RA diagnosis among GPs, inefficient referral to secondary healthcare, controlled process of biologics prescription and medical apprehensiveness about biologics safety. The leverage points included the improvement of national epidemiologic and clinical knowledge on RA, promotion of disease understanding among patients and GPs, promotion of biologics benefits among budget holders and overall spreading of the current treatment guidelines. In order to address the leverage points, the following key initiatives were selected: optimization of RA national registry; dissemination of rheumatic symptoms knowledge among patients; increased interaction between rheumatologists and GPs through clinical sessions; awareness regarding successful case reports about biologics; broader utilization of disease diagnosis and monitoring tool (e.g.DAS28) and implementation of hospital–based research to collect real-world data.  CONCLUSIONS: Most of the key barriers limiting access to biologics in RA in Portugal are upstream to rheumatology practice. Our findings suggest that actions should be focused at the primary care level to improve referral to rheumatologists. In addition, the collection of real-world data seems essential to characterize RA population, to improve the disease management and to increase the compliance with current treatment guidelines.