The Insured Package Advisory Committee (ACP) is an independent commission and advises the Executive Board of the National Health Care Institute. The ACP mainly advises on expensive medicinal products and treatments, but also on topics such as long-term care and oral care. The Committee considers the societal benefits in this regard. Putting prudence at the heart of these considerations, it determines whether we can afford certain care. The ACP consists of various experts, including physicians, economists and other experts with expertise and experience from a patient perspective. The chair of the ACP is assistant Prof. W. (Wija) Oortwijn.

ACP advisory reports: package criteria and societal considerations

The ACP advises the National Health Care Institute on whether a type of care belongs in the basic health insurance package. It tests such advisory reports against the 4 package criteria, among others: 

The 4 package criteria

Package criteria

Necessity
  • Is the disease severe enough? (high or low burden of disease)
  • Is the treatment too expensive for people to afford it themselves?

Effectiveness

  • Has the treatment been shown to work?
  • Does the treatment work at least as well as the standard treatment?

Cost-effectiveness

Is there an acceptable ratio between what the treatment costs and what it delivers to society?

Feasibility

Can inclusion in the basic healthcare package for that treatment be achieved in practice?

With this information, the ACP determines what benefits society most: it looks at the interests of patients as well as all those who pay premiums, which are all citizens in the Netherlands. Specifically, it concerns the interests of: 

  • The patients who are eligible for reimbursement of their treatments.
  • Patients with other disorders. Who naturally also want the treatment for their own disorders to remain reimbursable. They may also want new treatments to be reimbursed. 
  • All premium payers. This is to ensure that the money that we all pay collectively is spent on the right care.

Advisory reports of committees to the National Health Care Institute

The Health Care Institute assesses whether a type of care can be reimbursed from the basic health insurance package. It receives advisory reports for this from two independent committees: the Scientific Advisory Board (WAR) and the ACP. The WAR issues advice about the scientific support for an assessment. In doing so, the WAR looks at how well certain care works, for which patients it works and whether the assessment of cost-effectiveness is of sufficient quality. The ACP then determines what is in society’s best interest: it advises from the societal perspective whether a treatment or intervention should be included in the basic package. Indeed, the basic package should maximise the health gains for the entire of society. Among other things, the ACP looks at whether the cost of treatment outweighs the health gain. It looks at the interests of the patients who are eligible for reimbursement of a particular treatment, but also those of patients with other disorders as well as the interests of all premium payers. The ACP does not advise on all issues, but mainly when there is a high social impact. The final decision as to whether or not reimbursement from the basic healthcare package will take place lies with the Minister of Health, Welfare and Sport (VWS).