The National Health Care Institute has advised the Minister of Health, Welfare and Sport (VWS) to reimburse ripretinib (Qinlock) from the basic healthcare package after price negotiations. This medicinal product can be used in certain patients with a rare type of cancer in the stomach or intestines. The reason for this advice was the placing of the medicinal product in the so-called ‘lock procedure for expensive medicinal products’. This is a reassessment of an earlier advice from 2025.
Current state of affairs: advisory report sent to the minister
The National Health Care Institute has sent this advisory report to the Minister of VWS. The Minister makes the final decision whether or not to reimburse the medicinal product from the basic healthcare package.
Ripretinib is intended for adults with cancer in the stomach or intestines
Ripretinib is the active substance. The brand name is (Qinlock®). The product is a tablet that has to be taken once a day.
The medicinal product can be used in people with advanced gastrointestinal stromal tumour (GIST). GIST is a rare type of cancer that occurs in the connective tissue of the gastrointestinal system without obvious cause. The symptoms are also often unclear. A large GIST can cause symptoms such as nausea, vomiting or abdominal pain. Many patients also experience fatigue, dizziness and an increased risk of bleeding in the stomach or intestines.
Advice from the National Health Care Institute on the reimbursement of ripretinib
This is a reassessment of an earlier advice from 2025. At that time, the National Health Care Institute advised not to reimburse ripretinib (Qinlock®). That was because the marketing authorisation holder did not provide important information. That information was indispensable to determine whether this expensive medicinal product is worth the asking price. The marketing authorisation holder has now provided a modified economic analysis. This allowed the National Health Care Institute to determine the cost-effectiveness. That is the ratio of the medicinal product’s cost compared to the health gain for patients.
Based on the improved economic analysis, the National Health Care Institute advises the Minister of VWS to reimburse ripretinib (Qinlock®) from the basic healthcare package after price negotiations. Treatment may be reimbursed if the marketing authorisation holder lowers the asking price by at least 75%.
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) and the Insured Package Advisory Committee (ACP) advise the National Health Care Institute when issuing package advice. The final decision on whether reimbursement from the basic healthcare package will be made lies with the minister.
Explanation of the package lock procedure for expensive medicinal products
The minister has placed ripretinib in the 'lock procedure for expensive medicinal products' for this indication. A medicinal product in this lock procedure will not be eligible for reimbursement from the basic healthcare package until:
- there is a positive package advice from the National Health Care Institute;
- there are arrangements and safeguards for appropriateness in place;
- price reductions have been successfully negotiated with the marketing authorisation holder.
For more information, see the page ‘Lock procedure for expensive medicinal products’.