Combination therapies have contributed to recent improvements in cancer care but encounter significant challenges impacting patient access. These challenges, and the potential to address them, vary considerably across European countries. Consequently, there is substantial inequality in treatment opportunities which we have documented through quantitative, evidence-based analysis. Additionally, the upcoming European legislative reforms (EU HTA Regulation, EU pharmaceutical legislation) have been considered; these could provide an opportunity to address challenges or further exacerbate existing access problems. This research aims to quantify the impact of access challenges faced by novel oncology combinations, and show the ongoing delays and sub-optimal availability of such therapies in selected European countries, to highlight the need for solutions.