DutchNews.nl - Minister opts for 'no cure no pay' for some new medicines

Health minister Edith Schippers is to introduce the principle of no cure no pay for certain medicines, following advice from the health insurance council CVZ.

'This is certainly a good idea for new, expensive medicines that have not yet proved their worth,' Schippers told BNR Radio on Friday. 'It has little advantage for medicines that have been on the market for a long time in various varieties and where prices are low,' she said.

The CVZ is recommending an experiment with no cure no pay where the health insurer only pays for the medicine if it has a measurable effect on the patient. If there is no effect, the bill will be sent to the manufacturer.

The first medicine being tested under the new regime is Xolair, used in the treatment of severe asthma. According to the CVZ, Xolair has no effect on three out of ten patients. It costs €16,000 per patient per year. For those patients who show no improvement, the cost will be reclaimed from manufacturer Novartis.

The CVZ says it has already made an agreement with patients, lung doctors and Novartis and expects no cure no pay to save between €1m and €2m a year.

'This is the first time the cost of a medicine depends on the effect of the treatment,' a CVZ spokesman told BNR Radio. The organisation hopes other medicines will follow.

The move comes after the CVZ advised the minister not to continue payments for serious illnesses such as the rare metabolic diseases Pompe and Fabry, advice which Schippers said she would ignore.

Readers' Comments

This is one of the most foolish efforts at containing health care costs I have seen in any country. Who is to say whether it works or not? On the basis of what criteria? Confirmed by what other criteria? And when the manufacturer faces the threat of swallowing the cost, does no one realize that it will simply increase the price of other medications to compensate, leaving those who have nothing to do with any of this to pay the bill? Moreover, "no effect on three out of ten patients" means that in at least 70% of cases, the medication works. That's a pretty high %age. INsurance co's should not create gov't policy.

By Abigail | 31 August 2012 4:46 PM

I think this is an excellent idea & should be adopted by NHS in UK.

By Clive Sims | 31 August 2012 4:55 PM

What a ridiculous proposition! If the drug manufacturer is billed for the 3 out of 10 patients who don't show improvement, they will simply pull the drug from the market here rather than lose money - and so 7 out of 10 Dutch patients will suffer.
WHY does the health insurance council have such a strong say? Isn't their primary purpose to protect the insurance companies' bottom line? (certainly it's not the welfare of their insured members, at least not when the issue of cost of treatment is involved!) What's next? Depriving cancer patients of chemo when they don't have a "cure" - even though the chemo may put them in remission and prolong life while other treatments are developed?

By sailgirl | 31 August 2012 5:42 PM

Here's a conjecture, based on the vagueness of this report. Suppose a few doctors claim that med X wasn't effective (whatever that means) in a few cases. Then the medical firm will not be reimbursed. Well, the final step in this scenario is the withdrawl by the drug company of a potentially helpful med, that the Insurers and/or minister never felt like covering in the first place. Endgame: all authorities wash hands in (phoney) innocence, patients suffer and/or die.

By Husserl | 31 August 2012 7:16 PM

Doubt it will save anything. Manufacturer will just increase the cost of the medicine to allow for the expected percentage of people it won't help. Thus, if a medicine is only effective for 10% of people, they'll increase the price by a factor of 10 to cover the loss of income for the 90% it doesn't help. Admin costs will go up though...

By Paul | 31 August 2012 8:53 PM

A good idea? - 'just like the short lived no claims bonus that fizzled out leaving us with even more expense?

If it works, don't fix it, make some more cuts on the military instead, more chance of being invaded by the sea than some other country right?

By The visitor | 1 September 2012 4:18 PM

I wonder why academics and intelligent people never run for public office. There should be a test before anyone is allowed to run. These sorts of reports are startling in the level of stupidity coursing through the sick veins of government. Wish there was a drug for this...an affordable one that is.

By Al | 1 September 2012 7:03 PM