In Europe, there are at least as many reimbursement assessment processes in place as European countries. Some of these are transparent and clearly defined like the German AMNOG process, others are even more complex and sometimes even unclear, dependent also on the product of interest. Anyhow, the European Commission has already decided that a European joint assessment will come into place in 2025 starting with oncology and ATMP products. Anyhow, currently timelines and national processes to implement the outcomes of the European evaluation are still unclear and to be defined. Dr. Stefan Walzer and Dr. Elvira Mueller discuss the current status as well as issues and potential solutions for the new upcoming reimbursement start in Europe.