Commissioned by the National Health Care Institute, the Erasmus School of Health Policy & Management (ESHPM) has developed a disease model for a certain form of metastatic skin cancer, melanoma. A disease model is a mathematical method to compare the total health benefits and costs of different treatment sequences using existing studies. This enables us to investigate whether there is a good correlation between the cost of medicines and the health benefits for patients. ESHPM also investigated whether physicians in practice are using the treatments with the best ratio.

Reason: The National Health Care Institute wants to use disease models for assessments

The National Health Care Institute is working on the development and use of disease models for insured package assessments. Disease models allow the consequences of a treatment to be estimated in the longer term. The aim is to be able to assess the added value of new treatments better and faster. One of the disease models that has been developed focuses on the treatment of metastatic melanoma, an aggressive form of skin cancer, with expensive medicinal products. Using the disease model, the National Health Care Institute wants to investigate the optimal treatment sequences with the available medicinal products, as well as the health benefits of the different treatment options and the relationship between health benefits and costs.

Summary: outcomes of the disease model

The outcomes of the disease model have been discussed with healthcare providers and guideline developers. In general, we see that the medicinal products which, according to the disease model, provide the best balance between health benefits and costs are also the most widely used in practice. The results of the disease model are also included in the treatment guideline for physicians.

The use of disease models by the National Health Care Institute

In October 2022, the National Health Care Institute started a project called ‘Doorontwikkeling pakketbeheer: Implementatie gebruik ziektemodellen’ (Further development of insured package management: implementation and use of disease models). This project will run for 3 years, during which time we want to learn more about developing and applying disease models. The aim is to ensure that medicinal products are mainly prescribed where the costs are proportionate to the health benefits. The disease model for metastatic melanoma is part of this project.