[Separate pharmaceutical budgets: skating on thin ice].

Area of Science:

• Health Economics
• Pharmaceutical Policy
• Healthcare Management

Context:

• The Netherlands employs distinct pharmaceutical budgets for hospital, nursing home, and primary care settings.
• Recent developments include an increase in high-cost medications, the shift of complex hospital care to primary care, and the transfer of budget authority to health insurers.

Purpose:

• To analyze the pressures on patient access to adequate pharmacotherapy in the Netherlands.
• To highlight the need for reconsidering the distribution of pharmaceutical budgets.

Summary:

• Complex pharmaceutical funding structures in the Netherlands, combined with escalating drug costs and evolving healthcare responsibilities, are creating significant barriers to patient access to necessary treatments.
• The 'postcode lottery affair' exemplifies how geographical location can determine access to expensive drugs, such as trastuzumab.

Impact:

• Urgent reform of pharmaceutical budget distribution is required to ensure equitable patient access to pharmacotherapy.
• This situation underscores the need for a streamlined and equitable approach to drug funding within the Dutch healthcare system.