The current design approach recommended by seismic codes is often based on the use of uniform-hazard response spectra, reduced to account for inelastic structural behaviour. This approach has some strong limitations that have been highlighted in many studies, including not allowing a direct control of the seismic risk and losses. This study aims at quantifying the levels of safety and the costs associated with this design approach, and to investigate alternative design approaches that have been developed in the last decades. In particular, a risk-targeting approach and a minimum-cost approach are considered. The first one, allowed by US codes, aims at designing structures with the same risk of collapse throughout regions of different seismicity. The second one aims to minimize the sum of the initial construction cost and the cost of expected losses due to future earthquakes. The comparison of the three approaches is performed by considering, as an example structure, a fourstorey reinforced concrete frame building located in different areas in Europe, and by looking at the implications in terms of achieved safety levels, initial costs, and future losses. The study's results provide useful information on how the design criteria and the different hazard levels throughout Europe affect the cost and safety levels of seismic design.