Advice - Extension of reimbursement conditions for risdiplam (Evrysdi®)
The National Health Care Institute has advised the Minister of Health, Welfare and Sport (VWS) to also reimburse risdiplam (Evrysdi®) from the basic health insurance package for children aged between 0 and 2 months. This medicinal product can be used for children and young adults with the muscular disease SMA. Risdiplam is already included in the Medicines Reimbursement System (GVS) with additional conditions for reimbursement. If the Minister adopts our advice, these reimbursement conditions will be extended.
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 makes the final decision whether or not to extend the conditions of reimbursement.
Risdiplam is intended for certain children and young adults with the muscular disease SMA
Risdiplam is the active substance. The brand name is Evrysdi®. This medicinal product can be used for children and young adults with the muscular disease SMA. SMA is the abbreviation for spinal muscular atrophy. SMA is a severe progressive muscular disease that leads to greatly reduced mobility, curvature of the spine, loss of arm and hand function and paralysis of the respiratory muscles.
Advice from the National Health Care Institute on extension of the reimbursement conditions for risdiplam
The National Health Care Institute advises the Minister of Health, Welfare and Sport to extend the reimbursement conditions for risdiplam (Evrysdi®). These are the so-called List 2 conditions.
For more information on the GVS and the Lists 1A, 1B and 2, see page ‘Reimbursement of extramural drugs (GVS)’.
Conditions for reimbursement of risdiplam
Since 1 July 2023, the following conditions for reimbursement apply:
We advise the Minister of Health, Welfare and Sport to adjust these conditions as follows:
Only for insured persons up to and including 25 years old (at the start of treatment):
- with a clinical diagnosis of 5q SMA type 1, type 2 or type 3, or
- with a presymptomatic diagnosis of 5q SMA and one to four copies of the SMN2 gene.
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, personal expenses or whether you should pay a contribution, you could ask your health insurance provider.
How did the advice come about
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.