OBJECTIVES: Cost-per-QALY (CPQ) threshold can be a useful tool for resource allocation decisions but also may constitute an obstacle in access to the most-innovative, often life-saving but also expensive medicines. Since cancer is a major challenge for all healthcare systems, we investigated the impact of CPQ policy on new cancer drug reimbursement in 6 Central and Eastern Europe (CEE) countries: Poland and Slovakia (CPQ-driven countries), Czech Republic and Hungary (CPQ-oriented countries), Croatia and Romania (non-CPQ countries). METHODS: Basing on predefined criteria we selected 13 drug-indication pairs and considered their reimbursement status, time from registration to positive reimbursement decision and possible factors influencing reimbursement decision. Analyzes were performed for each selected country separately and in pairs grouped with regard to CPQ policy. The results were compared with indicators illustrating reimbursement systems, general cancer care and economics of participating countries. RESULTS: Generally, in all participating countries, cancer drugs generating lower CPQ values were more likely to be reimbursed. Analysis based on multinomial model adjusting for factors that might impact reimbursement decision confirmed significant role of CPQ value of a drug and GDP per capita of a country. Medicines generating higher CPQ values or evaluated in countries with lower GDP per capita are less likely to obtain positive reimbursement decisions. CONCLUSIONS: CEE countries have a different approach to CpQ application in reimbursement decisions. Access to oncology treatment for patients in CEE seems to be affected and not necessary improved  by CPQ implementation policy. Higher CPQ value results in more constrained access to cancer drugs and prolonged time to reimbursement decision. CPQ is not the only criterion in the reimbursement process and even when met does not inevitably transfer into positive reimbursement decision. It seems that currently factors related to economy of CEE countries may affect reimbursement by far more than strictly CPQ policy.