BACKGROUND: Treatment of non-small cell lung cancer (NSCLC) improved substantially in the last decades. Novel targeted and immune-oncologic drugs were introduced into routine treatment. Despite accelerated development and subsequent drug registrations by the European Medicinal Agency (EMA), novel drugs for NSCLC are poorly accessible in Central and Eastern European (CEE) countries. MATERIAL AND METHODS: The Central European Cooperative Oncology Group conducted a survey among experts from 10 CEE countries to provide an overview on the availability of novel drugs for NSCLC and time from registration to reimbursement decision in their countries. RESULTS: Although first-generation epidermal growth factor receptor tyrosine kinase inhibitors were reimbursed and available in all countries, for other registered therapies-even for ALK inhibitors and checkpoint inhibitors in first-line-there were apparent gaps in availability and/or reimbursement. There was a trend for better availability of drugs with longer time from EMA marketing authorization. Substantial differences in access to novel drugs among CEE countries were observed. In general, the availability of drugs is not in accordance with the Magnitude of Clinical Benefit Scale (MCBS), as defined by the European Society for Medical Oncology (ESMO). Time spans between drug registrations and national decisions on reimbursement vary greatly, from less than 3 months in one country to more than 1 year in the majority of countries. CONCLUSION: The access to novel drugs for NSCLC in CEE countries is suboptimal. To enable access to the most effective compounds within the shortest possible time, reimbursement decisions should be faster and ESMO MCBS should be incorporated into decision making.

Department for Respiratory Disease Jordanovic University Hospital Centre Zagreb Zagreb Croatia

Department of Chest Surgery Pest County Pulmonology Hospital Törökbálint Hungary

Department of Medical Oncology Military Medical Academy Sofia Bulgaria

Department of Medical Oncology Prof Dr Ion Chiricuta Institute of Oncology Cluj Napoca Romania

Department of Medicine 1 Medical University of Vienna General Hospital Vienna Austria and Central European Cooperative Oncology Group

Department of Oncology and Radiotherapy Medical University of Gdansk Gdansk Poland

Department of Oncology Hospital of St Zoerardus Zobor Nitra Slovakia

Department of Oncology University Hospital Prague Czech Republic

Department of Palliative Medicine University Hospital of Pulmonology Clinical Center of Serbia Belgrade Serbia

Department of Pulmunology National Koranyi Institute of Pulmunology Budapest Hungary

Medical Faculty Ljubljana University Clinic Golnik Ljubljana Slovenia

Vienna Cancer Center Medical University of Vienna General Hospital Vienna Austria and Central European Cooperative Oncology Group

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