The European Federation of Pharmaceutical Industries and Associations (EFPIA) has published its annual Patients Waiting to Access Innovative Therapies (WAIT) Indicator analysing access and availability of 168 new medicines across 36 countries, showing widening inequality and longer waiting times for patients in Europe. The data for medicines authorised between 2021–24 indicates a median time to availability of 532 days, ranging from 56 days in Germany to 1,201 days in Romania, with an 88% access disparity between countries. Access has also worsened, with 49% of medicines not available in 2025, 17% only available under restricted conditions, and full availability on public reimbursement lists declining to 28%, with delays linked to regulatory processes, evidence requirements and insufficient budgets. The report also highlights a decline in U.S. Food and Drug Administration (FDA) approved medicines subsequently approved by the European Medicines Agency and warns that factors such as the US Most Favoured Nation Policy (MFN), an uncertain EU market and companies prioritising the US may further impact patient access. EFPIA states that improving access will require faster processes, including ‘Day 1 access’ after approval and increased spending on new medicines, alongside collaborative action between Member States, the European Commission and stakeholders to reduce delays and improve availability.