This paper studies the di¤usion of biopharmaceuticals across European countries, focusing on anti-TNF drugs, which are used to treat autoimmune diseases (e.g., rheumatism, psoriasis). We use detailed sales information on the three brands Remicade, Enbrel and Humira for nine European countries covering the period from the …rst launch in 2000 until becoming blockbusters in 2009. Descriptive statistics reveal large variations across countries in per-capita consumption and price levels both overall and at brand level. We explore potential sources for the cross-country consumption di¤er-ences by estimating several multivariate regression models. Our results show that large parts of the cross-country variation are explained by time-invariant country-speci…c factors (e.g., disease prevalence, demographics, health care system). We also …nd that di¤erences in income (GDP per capita) and health spending (share of GDP) explain the cross-country variation in consumption, while relative price di¤erences seem to have limited impact. JEL Classi…cation: I11; L13; O33