The National Health Care Institute has advised the Minister for Medical Care to reimburse mavacamten (Camzyos®) from the basic health care package. This medicinal product can be used in certain patients with obstructive hypertrophic cardiomyopathy (oHCM). This is the medical term for a certain disease of the heart muscle. If the Minister adopts our advice, mavacamten will be included into the Medicine Reimbursement System (GVS). Only then will this medicinal product be reimbursed from the health care insurer's basic health care package. We do recommend additional conditions for reimbursement.
Mavacamten is intended for people with a certain heart muscle disease
Mavacamten is the active substance. The brand name is (Camzyos®). The medicinal product is a capsule that must be ingested.
The medicinal product can be used in certain patients with obstructive hypertrophic cardiomyopathy (oHCM). This is an enlarged heart muscle, causing blood to not be properly pumped from the left ventricle into the large body artery.
Advice from the National Health Care Institute on the reimbursement of mavacamten
The National Health Care Institute advises the Minister of Health, Welfare and Sport to reimburse mavacamten (Camzyos®) from the basic health care package under certain conditions. The recommendation is to include the medicinal product in List 1B of the GVS. Certain additional conditions, the so-called List 2 conditions, apply for mavacamten.
For more information on the GVS and the Lists 1A, 1B and 2, see page ‘Reimbursement of extramural drugs (GVS)’.
Conditions for the reimbursement of mavacamten
Only for an insured person with symptomatic (NYHA class II-III) obstructive hypertrophic cardiomyopathy (oHCM), who:
- either despite optimal beta-blocker or calcium antagonist use has persistent symptoms (NYHA ≥II);
- or has a proven contraindication or intolerance to beta-blockers or non-dihydropyridine calcium antagonists.
The prescription must be prescribed by a centre of expertise.
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 this 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
Mavacamten 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.