Routes in · version 2026-11-07
How each trial is actually paid for
This is the part that decides what is realistic. A trial being open is not the same as a trial being reachable, and the answer differs by country. On each trial page we show only the notes that apply to that trial and to where you live. Every note says who to verify it with; none of them is a promise.
S2 prior authorisation (EU planned treatment)
Your home-country insurer or health service can authorise planned treatment in another EU or EEA country and pay the foreign provider directly.
The insurer is obliged to authorise where the treatment is covered by your policy and cannot be provided at home within a medically justifiable time. For a cancer with no open trial and limited expertise at home, this is the route to raise for a trial or expert centre elsewhere in the EU. Apply through the insurer well in advance; every country has a National Contact Point for cross-border healthcare that explains the form and the timelines.
Verify with: EU National Contact Points for cross-border healthcare
0 if granted; the insurer pays the provider
EU consultation without prior authorisation
A medical consultation in another EU country cannot be made subject to prior authorisation, so a second opinion at an expert centre is a reimbursable outpatient visit.
Prior authorisation can be required for treatment involving an overnight stay or expensive equipment, but not for a consultation. Book directly, pay, and claim back from your insurer at the home-country rate.
Verify with: Directive 2011/24/EU, Article 8
Low; reimbursable at the home-country tariff
NIH Clinical Center: care at no cost, travel supported
Medical care at the NIH Clinical Center in Bethesda is provided at no cost to people enrolled on a study, and travel and lodging support is available, including for people living outside the US.
For non-US residents NIH provides airfare from the nearest US point of entry and a nightly hotel allowance. That makes Bethesda cheaper to reach than most US hospitals despite the distance. Ask the study contact what the current travel policy covers before booking anything.
Verify with: NIH Clinical Center: participating in a study
Care 0; transatlantic flight at your own cost, then supported
US trials at ordinary hospitals: routine care is billed
In the US a sponsor funds the study drug and study-specific scans, but the routine care around them is billed to insurance. Without US cover that bill falls on you.
Cost is documented as the barrier that stops roughly 45 percent of US patients joining trials, before any question of being a non-resident. Eligibility on paper does not make a US site reachable. One email to the study coordinator asking what a non-resident without US insurance would be billed settles it either way.
Verify with: The study coordinator listed on the registry record
Ask first; potentially very high
UK access: residence, not citizenship
Being a British citizen does not by itself entitle you to free NHS treatment; entitlement runs on being ordinarily resident in the UK.
The UK and EU agreed to continue a planned-treatment scheme equivalent to S2 from 1 January 2021, so an S2 issued by an EU insurer is the thing to ask about for a UK trial. Put the question to both your insurer and the trial coordinator, since sponsors sometimes cover trial-related care regardless.
Verify with: NHS: planned treatment abroad and the S2 route
Ask both; not free by citizenship
Named-patient access in the Netherlands
Two routes to a drug with no open trial: leveren op artsenverklaring, where the treating consultant applies for one patient and the IGJ assesses it, and company compassionate-use programmes assessed by the CBG, plus the DRUG Access Protocol platform.
All three are doctor-initiated, so they are a question for an appointment rather than something you can apply for yourself. The drug need not be registered in any country for the artsenverklaring route.
Verify with: CBG: compassionate use and named-patient supply
0; not a private purchase
Whole genome sequencing of the tumour (Netherlands)
Whole genome sequencing through the Hartwig Medical Foundation has been reimbursed from the Dutch basic package since 24 June 2025. It is what basket trials such as DRUP match against, and in a rare cancer it is the main route to an unexpected target.
Ask the treating oncologist to request it; the result is what a basket trial needs to match you to an off-label drug.
Verify with: Hartwig Medical Foundation
0 beyond the deductible
Free patient navigation
myTomorrows (Amsterdam) provides medically trained, multilingual patient navigators who search ClinicalTrials.gov, EU CTIS and ISRCTN and can support a doctor through an expanded-access application. Free to patients and families.
A navigator keeps searching after any single page stops being current. Use it alongside this site, not instead of your oncologist.
Verify with: myTomorrows for patients
0
Expert centres and reference networks
For a rare cancer, which hospital you are under matters more than in a common one. EURACAN is the EU reference network for rare adult solid cancers, and cross-border expert review within it is arranged hospital-to-hospital.
Ask your oncologist whether your case can be presented to a reference-network centre. For adrenal cancers specifically, ENSAT is the research network behind the European guidelines.
Verify with: EURACAN member centres
0 via the network; private opinions are typically several hundred to 1,500