Specialist drugs package management
Zorginstituut Nederland operationalises the established medical science and medical practice criterion by means of ‘therapeutic value’, whereby they examine whether the drug has a comparable value, an added value or a lower value than the current standard treatment or usual treatment. In principle, drugs with a comparable therapeutic value or an added value comply with established medical science and medical practice. This is not the case in the event of a lower therapeutic value, and in principle, such care will not be included in the insured package. This outcome therefore ends the assessment process.
Based on an evaluation of the package criteria (appraisal), Zorginstituut Nederland can advise the Minister to continue reimbursing a drug, whether or not subject to certain conditions such as price agreements, or to remove a drug from the package.