The National Health Care Institute has advised the Minister of Health, Welfare and Sport (VWS) to reimburse defatted peanut protein (Palforzia®) from the basic health care package. This medicinal product can be used for certain patients with a severe peanut allergy. If the Minister adopts our advice, defatted peanut protein will be included in the Medicine Reimbursement System (GVS). Only then will this medicinal product be reimbursed from the health care insurer's basic health care package. However, we do recommend additional conditions for reimbursement.
Current state of affairs: advisory report sent to the Minister
The National Health Care Institute has sent this advice to the Minister of VWS. The Minister makes the final decision whether or not to reimburse the medicinal product from the basic health care package.
Defatted peanut protein is intended for certain people with a severe peanut allergy
Defatted peanut protein is the active substance. The brand name is Palforzia®. The product is a powder in a capsule or a sachet and should be taken by mouth.
This medicinal product can be used for certain patients with a severe peanut allergy. Peanut allergy is caused by an abnormally strong reaction of the immune system to the nutrient 'peanut protein' in certain people. In these people, the body considers peanut protein as an intruder and responds to it. The most common reactions after eating peanut protein are skin reactions and fluid build-up in the skin due to leakage from blood vessels that can cause, among other things, the tongue to swell. Respiratory issues can also occur. In addition, ingestion of peanut protein can cause anaphylaxis. Anaphylaxis is a serious allergic reaction that can be very rapid and life-threatening. If patients take increasingly more defatted peanut protein on a strict exposure schedule, it may make them less susceptible to peanut protein. The marketing authorisation holder has requested reimbursement for certain people with a severe peanut allergy.
Advice from the National Health Care Institute on the reimbursement of defatted peanut protein
The National Health Care Institute advises the Minister of Health, Welfare and Sport to reimburse defatted peanut protein from the basic health care package. The reimbursement applies to patients who are 4 to 17 years old at the start of treatment. The advice is to include the medicinal product in List 1B of the GVS. For (Palforzia®), an additional condition, the so-called List 2 condition, applies.
For more information on the GVS and the Lists 1A, 1B and 2, see page ‘Reimbursement of outpatient medicines’.
Condition for reimbursement of defatted peanut protein
Only on the prescription of a paediatrician allergist/paediatrician - allergology expert.
More information or questions?
If you have any questions about this advice, please send your question to the National Health Care Institute via warcg@zinl.nl. If you have questions about the reimbursement of a medicinal product, the personal expenses or whether you should pay a contribution, please ask your health insurance provider.
How did the advice come about?
The Scientific Advisory Board (WAR) advises the National Health Care Institute about the assessment. The Minister makes the final decision whether or not to reimburse the medicinal product from the basic health care package.
Explanation about the reimbursement of medicinal products
Defatted peanut protein is an extramural drug. Extramural means: medicines for home use that can be obtained at the pharmacy with the prescription from a physician. They are only reimbursed from the basic health care package if they are listed in the GVS.