Lack of reimbursement for off-label drugs for new treatment indications vary from country to country in Europe. Often, off-label use of drugs is not reimbursed. However in daily clinical practice, especially for cancer and HIV drugs, in contrast to auto-immune diseases, reimbursement of these off-label drugs is possible due to strong media and political support.
Just like some people on this board being refused insurance coverage for V because the PA requirements are too onerous.