There is a recognized need to define barriers and develop putative solutions to the issue of patient access to personalised medicine across the EU. To meet this need, the Brussels-based European Alliance for Personalised Medicine (EAPM) assembled a multi-stakeholder panel to address the topics. Certain key challenges form the basis for this issue of Public Health Genomics. The authors outline them and present potential solutions to help embed personalised medicine into national healthcare systems. Part of the access problem concerns the EU’s directive on patients' rights to cross-border care. The effectiveness of the directive depends on collaboration at the European level. Unfortunately that sort of collaboration is in very short supply - a deficiency that threatens to undermine what is a well-intentioned initiative. Meanwhile, challenging fiscal times and an ageing population of 500 million potential patients across the EU’s 28 Member States, are making health care in Europe more expensive than ever. People are living longer and will, in most cases, be treated for not just one but several ailments during their lifetime. As such, a publication such as this is a valuable resource for EU/National politicians, healthcare planners, patients, medical professionals, and researchers.