OBJECTIVES:  Examine orphan drugs assessed by the German Federal Joint Committee (G-BA) between January 2011 and May 2015 and compare their assessments with those of other international HTA agencies. METHODS: GBA orphan drugs assessments between January 2011 and May 2015 and comparison with assessments conducted by HTA agencies in France, Netherlands, the UK and Canada, to examine similarities and differences in benefit evaluations, reimbursement and drug access. RESULTS: Germany has