A new medicine against breast cancer is not included in the basic package because the ministry considers it too expensive. Minister Kuipers (Public Health) writes this in a letter to the House of Representatives. Patients treated with the drug live on average more than five months longer.
It concerns the drug Trodelvy, a treatment of which should cost almost 69,000 euros per patient. According to an estimate by the Zorginstituut, 139 patients could be treated with the drug annually, which amounts to a total of 9.6 million euros.
According to the Healthcare Institute – which tests medicines before they are admitted – the medicine could be included in the basic package if the price were to fall by 75 percent. According to the Zorginstituut, the remedy is now ‘not cost-effective’. Choosing to reimburse the drug at the current price would be at the expense of other treatments. According to the institute, this leads to ‘health loss at the population level’.
Based on the advice, the ministry has negotiated with the manufacturer about a price reduction of 75 percent. He therefore did not agree with this, after which Kuipers decided not to include the medicine in the basic package.
‘Not socially responsible’
“I understand that this is an extremely disappointing outcome for patients and practitioners,” he writes. According to Kuipers, however, reimbursing the expensive drug would not be ‘socially responsible’. Expenditure on healthcare is already under pressure, and ‘to maintain solidarity in our system’, according to Kuipers, it is ‘necessary’ to curb prices and expenditure on medicines.
With the ever-increasing expenditure on medicines, according to Kuipers, it is ‘not inconceivable’ that it will happen more often in the future that it will not be possible to arrive at an ‘acceptable price’, as a result of which medicines, like Trodelvy, will not be reimbursed from basic insurance.
The number of resources that the ministry negotiates with suppliers is also increasing. “In the event of an unsuccessful negotiation, it is therefore the supplier who is not prepared to reach an outcome that leads to socially acceptable expenditure,” says Kuipers. During a debate with parliament last week, Kuipers stated that the pharmaceutical industry is one of the most profitable in the world.
If the manufacturer behind Trodelvy is still willing to meet the ministry’s demand, Kuipers will ‘reconsider’ his decision, he writes.