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Implementing managed entry agreements in practice: The Dutch reality check.

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Area of Science:

  • Health Economics
  • Pharmaceutical Policy
  • Health Technology Assessment

Background:

  • Conditional financing (CF) was implemented in the Netherlands from 2006-2012 for expensive hospital drugs.
  • This policy served as a coverage with evidence development (CED) framework, aiming for timely access while gathering data.

Purpose of the Study:

  • To evaluate the effectiveness and practical value of the Dutch CF framework.
  • Focus on the Health Technology Assessment (HTA) procedures within the CF system.

Main Methods:

  • Researchers extracted data on procedural, methodological, and decision-making aspects of HTA reports for CF-selected drugs.
  • A standardized data extraction form was used for independent information retrieval.

Main Results:

  • Of 49 drugs selected for CF, 12 underwent the full procedure, often exceeding the 4-year timeframe.
  • Outcome data was insufficient for 5/12 drugs to determine appropriate use or cost-effectiveness.
  • Reimbursement continuation was advised for 10/12 drugs, with 6 requiring further evidence generation; 2 drugs recommended for discontinuation were not delisted.

Conclusions:

  • While CF theoretically allowed rapid conditional drug access, practical implementation issues diminished its value.
  • Future CED schemes should integrate lessons from the CF experience to enhance their real-world impact on healthcare practices.