The National Health Care Institute has advised the Minister of Health, Welfare and Sport (VWS) not to reimburse upadactinib (Rinvoq®), in combination with a tapering course of corticosteroid, from the basic healthcare package. This medicine can be used for certain patients with giant cell arteritis. This is an inflammation of the large and medium-sized blood vessels. The reason for this advice was the placing of the medicinal product in the so-called ‘lock procedure for expensive medicinal products’. It has not been demonstrated that this medicinal product has an added value for patients.
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.
Upadacitinib is intended for certain people with inflammation of the large and medium-sized blood vessels
Upadacitinib is the active substance. The brand name is Rinvoq®. The medicinal product is a tablet that is taken daily. The medicine is given in combination with a course of tapering of corticosteroid. Tapering means that the patient takes a lower dose of the medication each time. A course of corticosteroid is used to reduce the inflammation in the blood vessels and thereby control the disease.
The medicine can be used in people with giant cell arteritis (GCA). GCA is an inflammation of the large and medium-size blood vessels. The inflammation can lead to thickening of the vessel wall, which can cause an artery to close. As a result, some tissues may not receive enough oxygen. Patients can experience symptoms such as headache, jaw pain or pain in the arms or legs when moving. In severe cases, patients can go blind. They are also have a higher risk of brain infarction or severe dilation of the artery in the chest.
National Health Care Institute advice on reimbursement of upadacitinib
The National Health Care Institute advises the Minister of VWS not to reimburse upadactinib (Rinvoq®) from the basic healthcare package.
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 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 upadactinib 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’.