Advice - reimburse omalizumab (Xolair®) for the treatment of severe asthma
The National Health Care Institute has advised the Minister of Health, Welfare and Sport to reimburse omalizumab (Xolair®) from the basic healthcare package for pharmaceutical care. This medicinal product can be used for certain patients with severe asthma. If the minister adopts our advice, omalizumab will be included in the Medicine Reimbursement System (GVS). Only then will this medicinal product be reimbursed from the health care insurer's basic health care package.
Omalizumab is intended for certain people with severe asthma
Omalizumab is the active substance; the brand name is Xolair®. The medicinal product is an injection that is administered under the skin (subcutaneously) every 2 or 4 weeks.
The medicinal product can be used to treat people with a certain form of severe asthma. Asthma is a chronic respiratory disease. The respiratory system consists of the lungs, trachea, throat and nose. People with asthma experience shortness of breath, coughing or wheezing. They have periods with few symptoms but may also develop asthma attacks with considerable shortness of breath. Sometimes they are even hospitalised because of an asthma attack. By ‘severe asthma’, we mean when people with asthma have at least 2 asthma attacks a year, despite using 1 or more inhalers that dilate the airways or inhibit inflammation.
Advice from the National Health Care Institute on the reimbursement of omalizumab
The National Health Care Institute advises the Minister of Health, Welfare and Sport to reimburse omalizumab (Xolair®) from the basic healthcare package for pharmaceutical care. Omalizumab is already reimbursable for inpatient care. The recommendation is that the medicinal product should be included on List 1A of the GVS. Specific additional conditions apply for Xolair®, known as the ‘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 omalizumab
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 National Health Care Institute advises the Minister. The Minister makes the final decision whether or not to reimburse the medication from the basic health care package.
Explanation about the reimbursement of medicinal products
Omalizumab is both an inpatient and an outpatient medicinal product. Inpatient means medicinal products used in hospital treatments. Outpatient means medicines for home use that can be obtained at the pharmacy with a prescription from a physician. They are reimbursed from the basic healthcare package if they are listed in the GVS.