The National Health Care Institute has advised the Minister of Health, Welfare and Sport (VWS) to remove the reimbursement conditions for certain SGLT2 inhibitors. These are the medicines canagliflozin (Invokana®), dapagliflozin (Forxiga®), empagliflozin (Jardiance®) and ertugliflozin (Steglatro®). SGLT2 inhibitors are already reimbursed from the basic healthcare package for certain patients with type 2 diabetes mellitus. As such, they are already included in the Medicine Reimbursement System (GVS). If the Minister adopts our advice, the List 2 conditions of these medicinal products will be removed. The medicinal products will continue to be reimbursed.
Download in English: GVS advice removal conditions for SGLT2 inhibitors for type 2 diabetes mellitus
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 has adopted this advice. The List 2 conditions will be removed per 1 August 2025.
SGLT2 inhibitors are intended for certain people with diabetes
Canagliflozin, dapagliflozin, empagliflozin and ertugliflozin are the substance names. Invokana®, Forxiga®, Jardiance® and Steglatro® are the brand names. The medicinal products are tablets to be swallowed.
SGLT2 inhibitors are used, among other things, to treat type 2 diabetes mellitus. In diabetes, the blood sugar level is too high. If this continues for a long time, it can damage the heart, eyes, kidneys, blood vessels and nerves. The first step in the treatment is a healthy diet and sufficient exercise. This may cause the blood sugar to drop. If this is not enough, medicines like SGLT2 inhibitors can lower the blood sugar level. They make the kidneys secrete more sugar, lowering the blood sugar level.
Canagliflozin, dapagliflozin, empagliflozin and ertugliflozin are types of SGLT2 inhibitors. The National Health Care Institute has investigated whether these SGLT2 inhibitors can be reimbursed for certain patients with type 2 diabetes and certain risk factors for developing cardiovascular disease. These include 4 of the following risk factors:
- smoking
- some form of hypertension (therapy-resistant hypertension)
- too high cholesterol
- aged 60 years or older
- chronic kidney damage
Advice from the National Health Care Institute on the discontinuation of the reimbursement conditions
The National Health Care Institute advises the Minister of Health, Welfare and Sport to reimburse SGLT2 inhibitors from the basic healthcare package for the specified group of patients. The National Health Care Institute also advises the Minister of Health, Welfare and Sport to remove the List 2 conditions for the SGLT-2 inhibitors canagliflozin, dapagliflozin, empagliflozin and ertugliflozin. The National Health Care Institute expects that removing the reimbursement conditions will be accompanied by limited additional costs.
The SGLT-2 inhibitors remain included in the GVS in List 1A (cluster 0A10BXAO V). The medicinal products will continue to be reimbursed for specific patient groups.
For more information on the GVS and the Lists 1A, 1B and 2, see page ‘Reimbursement of outpatient medicines’.
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 Minister of Health, Welfare and Sport (VWS) asks the National Health Care Institute to carry out an assessment. The Minister makes the final decision whether or not to reimburse the medicinal product from the basic healthcare package.
Explanation about the reimbursement of medicinal products
SGLT2 inhibitors are extramural medicinal products. 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 healthcare package if they are listed in the GVS.