A questionnaire on biomarker testing previously used in central European countries was extended and distributed in Western and Central European countries to the pathologists participating at the Pulmonary Pathology Society meeting 26-28 June 2019 in Dubrovnik, Croatia. Each country was represented by one responder. For recent biomarkers the availability and reimbursement of diagnoses of molecular alterations in non-small cell lung carcinoma varies widely between different, also western European, countries. Reimbursement of such assessments varies widely between unavailability and payments by the health care system or even pharmaceutical companies. The support for testing from alternative sources, such as the pharmaceutical industry, is no doubt partly compensating for the lack of public health system support, but it is not a viable or long-term solution. Ideally, a structured access to testing and reimbursement should be the aim in order to provide patients with appropriate therapeutic options. As biomarker enabled therapies deliver a 50% better probability of outcome success, improved and unbiased reimbursement remains a major challenge for the future.

Clinical Center University of Sarajevo Department of Pathology and Cytology Sarajevo Bosnia and Herzegovina

Clinical Unit for Pulmonary Cytology Department of Pathology and Cytology University Hospital Centre Zagreb School of Medicine University of Zagreb Zagreb Croatia

Department of Cardiac Thoracic Vascular Sciences and Public Health University of Padova Padova Italy

Department of Histopathology St James's Hospital Dublin 8 Ireland

Department of Pathology AmsterdamUMC Location VU Medical Center Amsterdam The Netherlands

Department of Pathology HUSLAB Helsinki and Uusimaa Health Care District Helsinki Finland

Department of Pathology Royal Liverpool University Hospital Liverpool England

Department of Pathology St Olavs Hospital Trondheim Norway

Department of Pathology University Hospital Copenhagen Ø Denmark

Diagnostic and Research Institute of Pathology Medical University of Graz Graz Austria

Institute for pulmonary diseases of Vojvodina Department for Pathology put dr Goldmana 4 Sremska Kamenica Serbia

Institute of Anatomical and Molecular Pathology Faculty of Medicine University of Coimbra Coimbra Portugal

Institute of Pathology University Hospital Schleswig Holstein Campus Luebeck Luebeck Germany

Laboratory for cytology and pathology University Clinic Golnik Golnik Slovenia

National Institute of Pneumology Pathology Department Bucharest Romania

National Tuberculosis and Lung Diseases Research Institute Department of Pathology Warsaw Poland

Nice University Hospital FHU OncoAge Laboratory of Clinical and Experimental Pathology Nice France

Pathology Department Herestraat Leuven Belgium

Pathology Department Passeig de la Vall d'Hebron 119 129 Barcelona Spain

Pathology Institute of Medical Genetics and Pathology University Hospital Basel University of Basel Basel Switzerland

Pathology Research Center Borstel Leibniz Lung Center Borstel Germany

The Fingerland Department of Pathology Charles University Medical Faculty and University Hospital Hradec Kralove Czech Republic

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