OBJECTIVES: The AMNOG assessment procedure requires that manufacturers submit indirect comparisons for the assessment of molecules in the absence of direct comparisons versus the G-BA appropriate comparator. The purpose of this study was to understand the role that indirect comparisons have in IQWiG’s assessment of added benefit and consequently also on the G-BA decision outcome.  METHODS: The IQWiG assessments and G-BA evaluations through the AMNOG process from initial implementation to the end of 2014 were analysed based on publications from the G-BA website. 104 molecules that had gone through the AMNOG procedure were identified and further categorised in order to determine whether they had submitted direct, indirect, or both types of comparisons. The G-BA publications by means of the classification score were used to source and quantify the outcome of the decision. RESULTS: