GVS advice midazolam (Midazolam Xiromed®) for the treatment of epilepsy

The National Health Care Institute has assessed whether oromucosal administration of midazolam (Midazolam Xiromed®) can be included in the Medicine Reimbursement System (GVS). Oromucosal means administration through the mucous membrane of the mouth. This medicinal product can be used to treat certain patients with protracted convulsive seizures (status epilepticus). This is the medical term for epileptic seizures that do not pass by themselves. The National Health Care Institute advises the Minister of Health, Welfare and Sport (VWS) to include midazolam on List 1B of the reimbursement conditions.

Indication for which reimbursement is requested

Midazolam is registered for oromucosal administration for the treatment of long-term, acute convulsive seizures in the age groups from 6 months to 18 years. Infants between 3 and 6 months are excluded from the reimbursement application. These patients are not treated at home, but in the hospital.

Recommendations from the National Health Care Institute

The National Health Care Institute advises the Minister of Health, Welfare and Sport to include midazolam on List 1B of the reimbursement conditions. 

Medicine Reimbursement System (GVS)

Midazolam is an extramural drug. Extramural drugs are medicinal products for home use, available at the pharmacy on prescription from a physician. They will only be reimbursed from the basic health care package if they are listed in the GVS. The amount of the reimbursement depends on the list the product is in. Interchangeable medicinal products are clustered in List 1A. These may be subject to a reimbursement limit. Unique medicinal products are listed in List 1B. There is no reimbursement limit for these products. Additional conditions may apply for reimbursement. In that case, a medicinal product is also listed in List 2.

The Scientific Advisory Board (WAR) advises the National Health Care Institute about the assessment. Based on the assessment, the National Health Care Institute sends an advisory report to the Minister of Health, Welfare and Sport. The Minister makes the final decision whether or not to reimburse the medication from the basic health care package. 

This report is a summary of recommendations by the National Health Care Institute. The original text is in Dutch.