OBJECTIVES: The objective of this study was to analyse the financing options for oncology drugs in Hong Kong and estimate their time to reimbursement compared to other countries.  METHODS: This study analysed the time to first inclusion of oncology drugs in the Samaritan Fund (based on the most recent SF publication) and compared to the time to reimbursement in countries with a similar GDP per capita, including Taiwan, Australia, the UK and the USA. Time to reimbursement was defined as the date of NHI formulary inclusion in Taiwan, publication of PBAC decision in Australia, publication of NICE Final Appraisal in the UK and FDA approval in the USA.   RESULTS: Currently, only select high-cost oncology drugs are covered under the safety net (Samaritan Fund (SF) or Community Care Fund) by the Hospital Authority in Hong Kong. Of 9 assessed drugs that are currently covered under the SF, the reimbursement coverage of all 9 drugs in Hong Kong lagged behind Taiwan, Australia, the UK and the USA, from months to years. On average, the reimbursement coverage of oncology drugs under SF in Hong Kong was 51.9 weeks behind the USA, 42.8 weeks behind Australia, 30.4 weeks behind the UK and 20.6 weeks behind Taiwan. These numbers were similar to the median reimbursement interval between Hong Kong and the USA, Australia, the UK, and Taiwan, which were 45, 38, 32 and 17 weeks, respectively.  CONCLUSIONS: The reimbursement coverage of oncology drugs is still limited and significantly delayed in Hong Kong compared to other countries with a similar GDP per capita. It not only lags behind western developed countries, like the USA, the UK and Australia, but also behind its neighbouring Asian country, Taiwan. There is therefore an urgent need for innovative solutions by the Hospital Authority to deliver access solutions for critical treatments.