Patients with advanced ovarian cancer who lack the BRCA mutation and those with metastatic breast cancer will no longer gain access to the drugs through the basic package. This is the first time high-cost drugs are being partially delisted upon review. The shift is part of a larger initiative under the Integrated Care Agreement, brokered by hospital providers and payers, to rein in skyrocketing cancer treatment costs.



Cost Pressures and Conditions for Reassessment
In 2012 the cost of medicines in the Netherlands accounted for >€1.1 billion, and 27% involved cancer medications. By 2021, that amount had grown to €2.

6 billion, and 59% was spent on treatments for cancer patients, even though those treatments alone have not led to major increases in the length of patients' lives. The compromise now calls for a review of whether treatments actually provide a life-extending or curative benefit and whether their effects differ by type of patient, such as those with genetic mutations.

Around 1,000 patients in the Netherlands use PARP inhibitors each year, at a cost of more than €30 million.

With the new decision, usage is expected to be cut by around half, which would release tens of millions of euros for other types of care.

Disagreement on the Quality of Research and Decision Making
A Reyners, chairwoman of the Dutch Society for M.