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Conditional reimbursement within the Dutch drug policy

Author

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  • Niezen, Maartje
  • de Bont, Antoinette
  • Stolk, Elly
  • Eyck, Arthur
  • Niessen, Louis
  • Stoevelaar, Herman

Abstract

In The Netherlands, conditional reimbursement is considered to be a promising approach to achieving more effective and efficient pharmaceutical care. Because of its formal status and nationwide regulation, conditional reimbursement may allow governments to better control medical decision-making. To evaluate the effects of conditional reimbursement on medicine use and its performance as a policy tool, we compared observed volumes of medicine use with expected volumes. In addition, we mapped the annual growth by analysing trends in the volumes of use of all conditionally reimbursed drugs; starting with the year the drug entered the market (using macro-level data). Next we explored five cases in depth (using micro-level data) in order to explore what fraction of individual prescriptions met the requirements. We also performed qualitative research (document analysis, interviews (NÂ =Â 65)) in order to obtain the stakeholders' perspectives on how the measure functions, as well as to interpret the case studies data further. The findings suggest that conditional reimbursement may be an effective policy instrument, but that several changes are needed to optimize its impact. These changes are predominantly related to transparency (e.g. conditions are set following clear procedures and criteria), legitimacy (conditions should be consistent with criteria for prioritization), feasibility of procedures to control appropriate use, and timely and appropriate commitment of the stakeholders.

Suggested Citation

  • Niezen, Maartje & de Bont, Antoinette & Stolk, Elly & Eyck, Arthur & Niessen, Louis & Stoevelaar, Herman, 2007. "Conditional reimbursement within the Dutch drug policy," Health Policy, Elsevier, vol. 84(1), pages 39-50, November.
    • Handle: RePEc:eee:hepoli:v:84:y:2007:i:1:p:39-50
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    References listed on IDEAS

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    1. Vuorenkoski, Lauri & Toiviainen, Hanna & Hemminki, Elina, 2003. "Drug reimbursement in Finland--a case of explicit prioritising in special categories," Health Policy, Elsevier, vol. 66(2), pages 169-177, November.
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    Cited by:

    1. Bognar, Katalin & Romley, John A. & Bae, Jay P. & Murray, James & Chou, Jacquelyn W. & Lakdawalla, Darius N., 2017. "The role of imperfect surrogate endpoint information in drug approval and reimbursement decisions," Journal of Health Economics, Elsevier, vol. 51(C), pages 1-12.
    2. Boon, Wouter & Martins, Luis & Koopmanschap, Marc, 2015. "Governance of conditional reimbursement practices in the Netherlands," Health Policy, Elsevier, vol. 119(2), pages 180-185.
    3. Wasem, Jürgen & Weegen, Lennart & Bauer, Cosima & Walendzik, Anke & Grande, Frederic & May, Uwe, 2015. "Regulatorische Handhabung der selektiven Erstattung von Arzneimitteln in den ausgewählten Ländern England, Niederlande, Frankreich und Schweden," IBES Diskussionsbeiträge 211, University of Duisburg-Essen, Institute of Business and Economic Studie (IBES).
    4. Tania Stafinski & Devidas Menon & Deborah Marshall & Timothy Caulfield, 2011. "Societal Values in the Allocation of Healthcare Resources," The Patient: Patient-Centered Outcomes Research, Springer;International Academy of Health Preference Research, vol. 4(4), pages 207-225, December.

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