Conditional reimbursement within the Dutch drug policy

M.G.H. Niezen, Antoinette de Bont, Elly Stolk, Arthur Eyck, Louis Niessen, Herman Stoevelaar

Research output: Contribution to journalArticleScientificpeer-review

Abstract

In The Netherlands, conditional reimbursement is considered to be a promising approach to achieving more effective and efficient pharmaceutical care. Because of its formal status and nationwide regulation, conditional reimbursement may allow governments to better control medical decision-making. To evaluate the effects of conditional reimbursement on medicine use and its performance as a policy tool, we compared observed volumes of medicine use with expected volumes. In addition, we mapped the annual growth by analysing trends in the volumes of use of all conditionally reimbursed drugs; starting with the year the drug entered the market (using macro-level data). Next we explored five cases in depth (using micro-level data) in order to explore what fraction of individual prescriptions met the requirements. We also performed qualitative research (document analysis, interviews (N=65)) in order to obtain the stakeholders' perspectives on how the measure functions, as well as to interpret the case studies data further. The findings suggest that conditional reimbursement may be an effective policy instrument, but that several changes are needed to optimize its impact. These changes are predominantly related to transparency (e.g. conditions are set following clear procedures and criteria), legitimacy (conditions should be consistent with criteria for prioritization), feasibility of procedures to control appropriate use, and timely and appropriate commitment of the stakeholders.

Original languageEnglish
Pages (from-to)39-50
Number of pages12
JournalHealth Policy
Volume84
Issue number1
DOIs
Publication statusPublished - Nov 2007
Externally publishedYes

Fingerprint

Medicine
Illegitimacy
Pharmaceutical Services
Pharmaceutical Preparations
Netherlands
Interviews

Keywords

  • Interviews as Topic
  • Legislation, Drug
  • National Health Programs
  • Netherlands
  • Policy Making
  • Qualitative Research
  • Reimbursement Mechanisms

Cite this

Niezen, M. G. H., de Bont, A., Stolk, E., Eyck, A., Niessen, L., & Stoevelaar, H. (2007). Conditional reimbursement within the Dutch drug policy. Health Policy, 84(1), 39-50. https://doi.org/10.1016/j.healthpol.2006.11.005
Niezen, M.G.H. ; de Bont, Antoinette ; Stolk, Elly ; Eyck, Arthur ; Niessen, Louis ; Stoevelaar, Herman. / Conditional reimbursement within the Dutch drug policy. In: Health Policy. 2007 ; Vol. 84, No. 1. pp. 39-50.
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Niezen, MGH, de Bont, A, Stolk, E, Eyck, A, Niessen, L & Stoevelaar, H 2007, 'Conditional reimbursement within the Dutch drug policy', Health Policy, vol. 84, no. 1, pp. 39-50. https://doi.org/10.1016/j.healthpol.2006.11.005

Conditional reimbursement within the Dutch drug policy. / Niezen, M.G.H.; de Bont, Antoinette; Stolk, Elly; Eyck, Arthur; Niessen, Louis; Stoevelaar, Herman.

In: Health Policy, Vol. 84, No. 1, 11.2007, p. 39-50.

Research output: Contribution to journalArticleScientificpeer-review

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AU - Niessen, Louis

AU - Stoevelaar, Herman

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Niezen MGH, de Bont A, Stolk E, Eyck A, Niessen L, Stoevelaar H. Conditional reimbursement within the Dutch drug policy. Health Policy. 2007 Nov;84(1):39-50. https://doi.org/10.1016/j.healthpol.2006.11.005