New study finds Dutch support higher drug costs, if benefits are clear
To better understand how the Dutch might prioritise cost when considering a socially acceptable price for specific medicines, researchers from Radboud University Medical Centre selected a group of 11 men and 13 women with diverse backgrounds to participate in a Citizens' Forum over two weekends.
They later ran an online survey among 884 people in the Netherlands to gather further insights and determine whether the results from the forum were broadly supported.
"The main aim of gaining insight into citizens' considerations regarding the societal acceptability of high-priced medicines was successfully achieved," lead researcher Prof. Rob Baltussen told Euractiv. Study background
The study, part of the Dutch Socially Acceptable Spending on Medicines programme (MAUG), examined medicines that are reimbursed through the Dutch basic health insurance system, which is mandatory for anyone who lives or works in the Netherlands.
Health insurers are not allowed to reimburse a medicine until the government negotiates its price with its manufacturer. These discussions take place behind closed doors.
To help the forum's participants gain more insight into the subject, an ethicist, a former senior employee of a pharmaceutical company, a senior employee of an NGO that works for fair access to medicines worldwide, and a former member of the Insured Package Advisory Committee (ACP) were enlisted to share their expertise.
"Despite the confidentiality of price negotiations, the provided information was deemed sufficient for participants to make nuanced judgements," Baltussen said.
The researchers wrote in their report that they did not select any patients to be part of the forum or questionnaire to avoid bias "because patients understandably focus primarily on their own health and access to care". Medicines offering complete recovery
The online survey used a 5-point Likert scale to measure how strongly citizens agreed with different reasons for accepting higher medicine prices.
Respondents were most supportive when a medicine offered complete recovery (4.16), enabled participation in society (3.87), or had a favourable cost-benefit ratio (3.85). Support was lowest when a medicine was significantly more expensive in the Netherlands than abroad, scoring just 1.95.
The results of the online survey largely confirmed the outcome of the Citizen Forum, that citizens are willing to accept a higher price for a medicine if it provides significant health benefits, offers fair access, and contributes to social participation. 'Reinvest 50% of profits in R&D'
Participants said the government, where necessary, should refuse to reimburse expensive medicines that are not sufficiently effective or whose prices are socially unacceptable.
They recommended that pharmaceutical manufacturers should be transparent about the price structure of medicines, set reasonable profit margins to prevent excessive prices and keep healthcare affordable.
They also said the companies should reinvest at least 50% of their profits in research and development.
The participants further recommended that citizens should understand there are limits to what the Netherlands can afford to spend on healthcare and that they should set realistic expectations.
Researchers said they expected the topic to appear regularly in the run-up to the Dutch general elections set to take place this October.
The study's results will be included in a recommendation on drug pricing to be submitted to the Health Ministry in the coming months.
"This research confirms that there is support for the difficult decisions we as a society have to make," Baltussen said. "With these insights, politicians can develop healthcare policies that are both effective and supported by society."
[Edited by Vasiliki Angouridi, Brian Maguire]
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