Wednesday 12 May 2021

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.
Asthma
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.
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