Prescription Charges in the Netherlands

Prescription Charges in the Netherlands

Background

The health care system in the Netherlands is made up of a mixture of public and private funding. There are various types of insurance covering hospital care and primary care, which together account for 43% of all health care expenditure. About 60% of the population are compulsorily insured by public health insurance funds which are income linked. The Dutch government determines the cover that these funds provide. This includes in-patient services, primary care and prescription medication [2]. Prescription medications are reimbursable if they form part of an approved list of medications; this includes products that are generally reimbursable and a number of prescription medications which are only reimbursable under special circumstances [1].

People who earn more than €32,600 1 (£23,051.41), or who are not aged 65 or over, are not eligible for public insurance and have to take out private insurance. Private insurance companies set their own premiums, generally based on the risk of illness. A special private insurance scheme ensures affordable care for the elderly and the chronically ill [3].

The Dutch government are introducing a new health insurance system in 2006, consisting of a single compulsory standard insurance scheme for curative care. Under this new system there will no longer be a distinction between public and private health insurance [3].

Patient co-payments

In 2005-2006, patients have to make a payment towards their prescription medication for annex 1A drugs equal to the difference between the reference cost and the cost of the medication on the shelf. Up until 2006, in reality this has meant that very few prescription medications attracted any co-payment (0.5% of pharmaceutical expenditure). In 2006 however, it is likely that this will change with patients paying the difference between the lowest priced drug in each reference price group and the cost of the drug they are prescribed [1].

Co-payments in the Netherlands 2005 [1] (Group [4] and Contribution):

  • Annex 1A: similar interchangeable products reimbursed according to a reference price system: Difference between the reference price and the cost of the drug on the shelf.
  • Annex 1B: Unique products not part of the reference price system: 0%.
  • Annex 2: Medicines reimbursed under specific circumstances: 0%.

Resources

Notes

  1. Bronner, M et al (2005) Pharmaceutical Pricing & Reimbursement 2005: a concise guide, PPR Communications Ltd.
  2. euro.who.int/pharmaceuticals/Topics/Overview/20020416_1 [Accessed 13/0/2006].
  3. minbuza.nl/default.asp?CMS_ITEM=MBZ426386 [Accessed 13/01/2006]
  4. Over the counter medication was removed from the reimbursement system in 2004

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