Cost-Effectiveness: Dutch Plan Slammed

The Dutch research-based drug industry association Nefarma has attackeda recommendation by the Council for Health and Social Services that cost-effectiveness be introduced as a criteria for reimbursement of pharmaceuticals by the health funds (Marketletter February 3).

Nefarma says that examining cost-effectiveness demands unequivocal, objective and verifiable criteria, but there is at present no international consensus on this. The association also claims that there is currently a danger that health-economic studies are being misused in the Netherlands as a means of keeping new drugs off the market, and it states that elements of such studies should not be used "at random" in order to achieve the cost-cutting objectives of the Dutch government.

Especially in the case of treatments for chronic illnesses, cost-effectiveness can only be determined if the medicine is used by large groups of patients in daily life. This requires very costly and time-consuming studies, and it is unreasonable to demand that a company finance this research in anticipation of possible reimbursement, says Nefarma. If companies are forced to conduct this additional research they will question whether to introduce new drugs into the Netherlands, and the national supply will lag behind the rest of Europe, where the cost-effectiveness criterion is not used, it warns.