New and Affordable Medicines in the Netherlands: Tracing the Dutch Government’s Policy Commitments and Actions

Report | 6 December, 2018 | Download PDF

Similar to its European Union (EU) neighbours, the Netherlands struggles to afford the ever-increasing prices for new medicines. One of the first signals of a turning tide came in 2015 when nivolumab was marketed at a total projected cost of €200 million per year to treat patients in the Netherlands with advanced stage, non-small-cell lung cancer. This exorbitant cost, roughly equivalent to an eighth of the Netherlands’ total expenditure on inpatient pharmaceuticals, triggered a landmark decision by the Dutch government to stop automatically reimbursing new, expensive medicines used in hospitals and, instead, negotiate better prices.

This momentum continued during the Dutch Presidency of the Council of the EU from January to June, 2016. The official programme of the Presidency committed to examining how medical innovations can reach patients faster ‘at a socially acceptable cost’. It emphasised the importance of safeguarding access to innovative and affordable medicines, therefore committing to strengthening Member State voluntary cooperation on issues of pricing and market access.

Since then, the Netherlands has been among the few EU Member States to resolutely and vocally commit to addressing the systemic problems that permit and sustain high medicines prices. The Dutch government has openly questioned the business model for pharmaceutical innovation and its reliance on patent and other intellectual property and regulatory exclusivities.

Recently, the government made strong statements about safeguards for the flexible implementation of patent rules for public health. In doing so, the government effectively broke ranks with other EU countries in multilateral fora; instead, the Netherlands seems to try to find new paths synonymous with its changing domestic policies for drug development and pricing.

Towards the end of her term, then Minister of Health, Welfare and Sport (from 2010–2017), Edith Schippers called for urgent and far-reaching revisions to Dutch medicines policy. Some of these policy initiatives are now being continued by the current Minister for Medical Care and Sport, Bruno Bruins. Both Ministers are members of the People’s Party for Freedom and Democracy (Volkspartij voor Vrijheid en Democratie or VVD), a conservative liberal political party. Now, one year into the term of the Rutte III Cabinet, this report collects the Dutch government’s commitments to the development and marketing of new, affordable medicines and, where possible, assesses their implementation. Read the report here.

Study author, Dr Katrina Perehudoff, gives a summary of the report and its findings: