This study compares access to and availability of orphan drugs in the five largest markets in the current European Union (EU): the United Kingdom, France, Germany, Italy and Spain. As defined in the article itself, "availability" is the term used to refer to the possibility of prescribing the drugs, while "access" refers to the full or partial funding of the drugs by the relevant public health service. An additional objective of this analysis is to compare access times to orphan drugs in the selected countries by counting the number of months between marketing authorisation and publication of funding recommendations in each country.