News item | 11-11-2025 | 5:00 PM
Minister Jan Anthonie Bruijn of Health, Welfare and Sport (VWS) has decided to extend the lock placement of 3 expensive medicines, because negotiations with suppliers have not currently led to a socially acceptable price. This means that the medicines are not yet included in the basic health insurance package.
This concerns the medicines Xenpozyme (olipudase alfa), Carvykti (ciltacabtagene autoleucel) and Enhertu (trastuzumab deruxtecan). In the case of the drug Enhertu, it concerns the treatment of HER2-low breast cancer. Enhertu will continue to be reimbursed for the treatment of HER2-positive breast cancer
Intensive negotiations
Despite intensive negotiations, no agreement has been reached on a price that is in line with the underlying advice of the Healthcare Institute. Although the Healthcare Institute concluded that the medicines have added value for treatment, the expected health benefit does not outweigh the high price. The prices asked do not come close to what we in the Netherlands find socially acceptable for the health benefits of these medicines.
Minister Bruijn: “It is difficult for me that I had to make this decision. I realize that these medicines can provide health benefits. I understand that this decision is very disappointing for patients and their loved ones, who have placed their hopes on these medicines. But the prices of these medicines must be in proportion to the health benefits they provide. If that is not the case, it is not a responsible expenditure of the healthcare budget. In that case, I cannot explain to all patients and premium payers that I am including the medicine in the basic package. The high prices that these suppliers put pressure on solidarity in our healthcare system. If we do not control expenditure on these expensive medicines, this will eventually mean that we can no longer afford other effective and efficient care. I must also take into account the consequences for the (future) patients who depend on that care.
The medicine lock
The medicine lock (the lock) is an instrument to temporarily exclude expensive new medicines from the basic package as soon as the expected expenditure is too high. During that period, experts from the Healthcare Institute assess whether the drug meets 4 so-called package criteria: effectiveness (does the drug work for the patient at least as well as the standard treatment in the Netherlands?), cost-effectiveness (is the price in proportion to the health gain achieved when using the drug?), necessity (is it necessary, due to the costs of the drug and the severity of the disease, that the drug is reimbursed from basic insurance?) and feasibility (is it practically feasible to reimburse the drug?).
Based on the advice of the Healthcare Institute, the minister negotiates the price with the supplier. Only when socially acceptable agreements have been made can the drug be withdrawn and included in the basic package.
Social support
Recent citizen research (from the Socially Acceptable Expenditure on Medicines (MAUG) program) shows that Dutch people believe that the government should be critical when reimbursing expensive medicines. If the effectiveness is limited or the price is socially unacceptably high, it must be possible to refuse reimbursement. People indicate that it is very important that there is transparency in pricing and that there must be good substantiation of why the manufacturer charges a certain price for a new product.
Minister Bruijn remains prepared to reassess the lock placement of the 3 medicines if suppliers still come to a socially responsible price.