The European Federation of Pharmaceutical Industries and Associations, EFPIA, has published its 2025 Patients W.A.I.T. Indicator, updating its annual benchmark of public reimbursement for centrally authorised medicines. The survey covers 168 innovative medicines approved between 2021 and 2024, with availability measured on 5 January 2026.
EFPIA defines availability as inclusion of a centrally approved medicine on a public reimbursement list. It does not measure prescribing, uptake or patient-level use after listing.
Across the EU27, 45% of the medicines were available, compared with 46% in the previous survey. Germany reported the highest availability, at 93%, followed by Austria, Italy, Switzerland and Spain. Several smaller or lower-spending markets reported much lower levels, with Turkey, North Macedonia and Bosnia at 5%, although EFPIA flags incomplete data for North Macedonia and Bosnia.
The proportion of medicines with full availability has continued to shift. EFPIA reports that full public availability across the EU fell from 42% in the 2019 comparison to 28% in the 2025 survey, while limited availability rose from 6% to 17%. Non-availability also increased slightly, from 46% to 49%.
The limited-availability category should be read with care. Depending on the country, it may cover HTA-recommended subgroups, managed access protocols, named-patient access, pending-financing arrangements or managed entry agreements. The figures therefore show more conditional reimbursement, but they do not distinguish evidence-based targeting from budget management or interim access while assessment continues.
Time to availability also remains uneven. EFPIA reports an EU27 median of 532 days, ranging from 56 days in Germany to 1,201 days in Romania. The average time to availability increased to 597 days, from 578 days in the previous survey.
The report gives an industry-commissioned view of European access variation. Its main value is comparative: it shows that countries differ not only in whether new medicines reach reimbursement lists, but also in the timing of listing and the extent to which reimbursed use is restricted.
Source: European Federation of Pharmaceutical Industries and Associations, EFPIA
Link: Patients W.A.I.T. Indicator 2025 Survey
Date: 19 May 2026
