ACF Assesses Dutch Govt Drug Cost Curbs

Pharmaceuticals are the most important market in terms of sales for ACF Holding, the Dutch health care group. But, says the company in its annual report for 1994, the Dutch government's determination to tackle rising national spending on drugs means the sector is likely to remain volatile for some time.

Cost controls have been aimed at demand, targeting mainly doctors, pharmacists, insurers and patients. The centerpiece of this policy is the price reimbursement system, which governs refunds for products covered by the Healthcare Reimbursement Act and which has had a significant effect on costs. However, the government believes costs are still rising too fast, partly because of the introduction of expensive new drugs, but as some of these offer major therapeutic advances and improve the overall quality of care, curbs on their use have had to be selective. For example, from July 1, 1993, new drugs became reimbursable provided no existing drugs could treat the condition; this measure has now been extended to July 1, 1995.

Homeopathic medicines were removed from reimbursement on July 1, 1993, and most over-the-counter drugs on january 1, 1994, with further cuts likely. Also, the government has said that in 1996 it wants to return to the Act's original focus of uninsurable risks and long-term care provision, which implies that drugs will be transferred back to semi-state health insurance and private health policies, from which they were removed in 1992.