New and innovative drugs are costly. Some drugs cost millions of euros per patient. Because these drugs are covered by insurance after the minister’s approval, the costs burden the ever-increasing healthcare costs. According to André den Exter, Associate Professor of Health Law at Erasmus School of Law, choices must be made about the insurance coverage of these types of drugs. In an opinion piece in Trouw, he explains that politicians must discuss the limits of the affordability of healthcare.
Den Exter gives some examples of life-saving drugs that are not just very promising but also extremely expensive: “the discussions about Zolgensma, a promising drug against lethal muscle disease, were mostly about the price, which was 1.9 million euros per patient. In the meantime, the minister has approved, and the basic healthcare package covers Zolgensma. (…) In addition to Zolgensma, new negotiations have started about Risdiplam, the fluid version of Zolgensma: 4 to 7 million euros per patient. The latest asset is Libmeldy, a promising drug against a rare metabolic disease. Effort: 2.9 million euros per patient.”
Limits to affordability
According to Den Exter, this situation is not durable: “these examples painfully reveal that the affordability of healthcare has its limits. Our preparedness to pay absurd prices increases the list of new promising drugs, which has predictable consequences. Already, costly drugs are repressing other types of healthcare.”
Because the healthcare agreement has limited the costs for specialistic healthcare, the minister will at some point have to choose between different treatments, explains the Associate Professor of Health Law: “that requires political courage because it leads to the abstinence of medical and urgent care, and the premature death of mainly young patients.”
In the end, this issue can not be resolved by medical professionals, which is why parliament must play a key role, according to Den Exter: “What is the maximum price society wants to pay per gained year of life? A maximum will provide clarity for all those involved. Because this maximum has direct consequences for access to drugs, the establishment can not be left to non-democratic advisory committees. This maximum will irrevocably lead to a social debate about the limits of affordability of health care, and that is profit.”
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Read the entire opinion article of Trouw here (in Dutch).