Immune checkpoint inhibitors, including Bristol-Myers Squibb’s Opdivo, Merck & Co.’s Keytruda, and Roche’s Tecentriq, are revolutionizing the therapeutic strategies for several cancers. This report focuses on: malignant melanoma, primarily the adjuvant setting, which has been newly penetrated by the immune checkpoint inhibitors; bladder cancer, for which reimbursement of the drug class under study is not proving to be straightforward; and, squamous cell carcinoma of the head and neck (SCCHN), an indication with few labeled treatments and high unmet need. As novel immune checkpoint inhibitor therapies prepare to enter the markets under study, and label expansions for existing treatments loom large on the horizon, optimal market access opportunities beckon in France, Germany, Italy, Spain, and the UK, but payer-imposed reimbursement restrictions and cost-containment strategies will increasingly play a pivotal role in shaping medical oncologists’ prescribing practices for these high-cost therapies, and manufacturers must be prepared to compromise in order to maximize return on investment.


  • What are the key driving forces and constraints that influence European payers’ reimbursement decisions for immune checkpoint inhibitors in malignant melanoma, bladder cancer, and SCCHN?
  • How do reimbursement policies at the national, regional, and local levels shape prescribing preferences? How do payers prioritize diminishing budgets and monitor immune checkpoint inhibitor prescribing accordingly?
  • Do interviewed payers and surveyed prescribers believe that efficacy of existing and emerging therapies justifies their cost? Which treatments do they think perform best on clinical and other attributes? How will prescribing patterns change with the launch of novel immune checkpoint inhibitors?
  • What can manufacturers do to encourage optimal P&R terms and to drive uptake? How might evolving healthcare reforms and cost-containment strategies affect reimbursement and product positioning? To what degree will payer policy impact prescribing?


European Access & Reimbursement provides integrated brand-level and country-specific analysis of primary market research conducted with payers and prescribers to examine reimbursement dynamics and evaluate the impact of payer policy on prescribing behavior.


France, Germany, Italy, Spain, and United Kingdom


  • Survey of 247 medical oncologists across the top 5 European markets (49-50 per country)
  • Interviews with 10 payers top 5 European markets (2 per country).


Keytruda, Opdivo, Tecentriq, Yervoy, spartalizumab, Imfinzi, tremelimumab, Bavencio


  • Actionable recommendations to optimize market access
  • Market access success and stumbles
  • Market access roadblocks
  • Pricing and reimbursement dynamics
  • Impact of payer policy and coverage on prescribing
  • Market access outlook for emerging therapies

Table of contents

  • Immune Checkpoint Inhibitors - Access & Reimbursement - Detailed, Expanded Analysis - Top Five European Markets (EU)
    • Access & Reimbursement - Immune Checkpoint Inhibitors - Top Five European Markets - 2019

Author(s): Henrique Duarte; Anamika Ghosh, Ph.D.

Henrique Duarte is an analyst on the Global Market Access Insights team at Decision Resources Group, primarily focusing on European market access. He is responsible for monitoring, analyzing, and reporting on global market access through the production of DRG’s Global Market Access Solution (GMAS) and Access & Reimbursement products. Henrique’s specific focus is on all aspects of market access in the EU5, as well as in select Latin American countries. Henrique holds a pharmaceutical science degree from the Universidade Lusófona and a postgraduate certificate in health economics from the University of York.

Anamika Ghosh, Ph.D.,is a Senior Analyst for the oncology team at Decision Resources.

Prior to joining DRG, Anamika was a Research Lead with Evalueserve Pvt. Ltd., a business solutions provider to pharmaceutical companies. At Evalueserve, she worked on various strategic insights solutions for a variety of indications, including oncology, cardiovascular, ophthalmology etc. Anamika holds a PhD on host-pathogen interactions in the context of M. tuberculosis from the International Centre for Genetic Engineering and Biotechnology (ICGEB), New Delhi, India, where she also worked as a Research Associate working on Dengue viral infection.