Health Minister Firm On Dutch Drug Reimbursement

Dutch Health Minister Els Borst has confirmed that with few exceptions, the list of medicines which are not reimbursable will remain closed. In a lengthy written statement to parliament, she notes that savings made from new drugs being refused entry to the market because there are no comparable products already on the market have totaled at least 540 million guilders ($324.6 million) since July 1, 1993.

Ms Borst says that while new drug products should be genuinely necessary and a positive addition to what is already available, their introduction should not have unacceptable consequences in terms of cost. To this end, she is establishing a working group, with a budget of 20 million guilders ($12 million) to examine new products to decide whether they do represent a genuine benefit, and whether they should be placed on List 1A (reimbursable) or List IB (not reimbursable). She hopes that the extra costs involved can be covered by savings elsewhere within the health care system.

However, the pharmacists' association, the KNMP, says that the opening of List IA is necessary and possible, with careful controls. The choice of drugs should remain with the physician, with the government and insurers only becoming involved if the controls are not adhered to. Freezing the present availability of medicines reduces the quality of care, says the KNMP, reported in the pharmacists' journal, the Pharmaceutisch Weekblad.