OBJECTIVES: Other economic evaluation tools than the classical cost-effectiveness (CE) analysis exist but the acceptance of these by decision makers is unknown. We assessed the value of these new methods among experts and decision makers in Europe through a survey. METHODS: Qualitative structured phone-interviews were conducted among experts and decision makers in eleven European countries over a one year period to evaluate the current and future use of additional economic evaluation methods for reimbursement decisions on vaccines. The five additional methods were: 1) Return on Investment (RoI); 2) Multi-Criteria Decision Analysis (MCDA); 3) Quality of hospital care (QoC); 4) Healthcare Budget Optimisation (BOM), and 5) Macro-Economic Analysis (MEA). RESULTS: One hundred and seventy experts were contacted with a 15% participation rate (25 experts participated). In countries where CE is formally used like Belgium, the Netherlands, the UK and the Nordic countries, the additional methods were considered as relevant by most experts to value vaccines: RoI (61%), MCDA (62%), QoC (54%), BOM (54%) and MEA (61%). They were however not considered to be able to replace CE except for MEA (14% reported that it could replace CE versus 0% for the others). In countries where CE is not formally used, the proportion of experts considering them as relevant was lower except for the BOM: RoI (46%), MCDA (46%), QoC (18%), BOM (60%) and MEA (33%). Most reported barriers for use of the alternative methods were: no political interest, unfamiliarity with these methodologies, and lack of robust input data to conduct the evaluation. The method selection was most influenced by the appropriateness to the decision-making question, the country, and the vaccine or disease type assessed. CONCLUSIONS: Creating awareness on additional economic evaluation methods may support and facilitate the vaccine reimbursement decision-making process in Europe alongside the current CE analysis.