Biosimilars are becoming more widely available across Europe, with many payers at each level involved in decision-making regarding their market access. Despite recognition of the benefits of biosimilars (reducing cost of treatment thus freeing up resources to treat more patients, maximising health care outcomes and enabling cost savings to support new innovation) decision-making and access processes are still finding their place within each country’s healthcare system. This study investigates the local market access needs of European countries in relation