OBJECTIVES: Chimeric antigen receptors T-cell therapies (CAR-T) have demonstrated excellent remission rates in haematological cancers but are associated with a high treatment cost and logistical burden. This research was completed to identify the key challenges CAR-T therapies pose to payers in the EU5 and how these challenges can be mitigated. METHODS: A web-based survey was administered through the Rapid Payer Response™ online portal (RPR^®) to 25 payers with experience in HTA and reimbursement decision-making for oncology treatments in France, Germany, Italy, Spain, and the UK, 5 payers per country. Payer profiles included former-members of NICE and the SMC in the UK, ex-CEPS and ex-TC payers in France, ex-GBA and SHI payers in Germany and both national and regional level payers in Italy and Spain. Responses were collected through RPR^® in 5 days and analysed via Microsoft™ Excel. RESULTS: Payers consider current HTA processes to be sufficiently robust to evaluate CAR-T therapies and do not expect any additional processes to be implemented; however, payers do expect patient access schemes (PAS) and outcomes-based agreements to play a significant role in the reimbursement of CAR-T therapies in the future due to the concerns regarding budget impact and the infrastructure requirements to administer CAR-T therapies. CONCLUSIONS: Despite the substantial improvement in clinical efficacy demonstrated by CAR-T therapies, manufacturers will need to actively engage with payers and physicians to develop practical solutions to the logistical and cost-based challenges affecting reimbursement.