OBJECTIVES Medical devices constitute a set of important health technologies for the care of patients. While there are similarities between some reimbursement systems, each market has its own unique characteristics. This article focuses on the reimbursement procedures for medical devices in the DACH countries (Austria, Germany, Switzerland), and aims at finding commonalities in payer requirements and reimbursement pathways. METHODS Reimbursement application pathways for inpatient and outpatient medical devices were evaluated for Austria, Germany and Switzerland. The key items being analysed for similarities and differences in each setting were transparency, clinical and health economic evidence requirements, submission timelines and the length of the whole reimbursement application process. RESULTS In the inpatient setting, the evidence requirements for clinical data are different between the analysed countries: The lowest clinical evidence requirements are seen in Germany, while the highest are given in Switzerland (in some scenarios). In terms of health economics the requirements are medium to low. A medium rating was given for Austria and Switzerland (in some scenarios) as a health economic analysis is required (e.g. cost comparison), and a low rating was applied to Germany as limited economic information (cost assessment/comparison) needs to be submitted. The length of the application process is well defined in Austria and Germany and vague in Switzerland. In the outpatient setting the requirements for clinical and health economic data are significantly increasing. Clinical requirements are getting close to pharmaceutical methods whereas health economic evidence is requested in all DACH countries. The length of the reimbursement process is not clearly defined in all three countries. CONCLUSIONS Despite varying reimbursement processes within the DACH region, there are some important similarities between the evidence requirements which may help manufacturers to guide market access and reimbursement strategy decisions in order to drive successful submissions and applications of innovative medical devices.