The Belgian government is now grappling with a staggering €6 billion price tag for medicines, De Standaard reports.
Eight out of the ten most expensive drugs are under government contracts. The growing expense of these life-saving treatments has raised concerns over their financial sustainability and the urgent need for reforms in healthcare spending.
While advancements in medical science have led to significantly improved cancer treatment outcomes, the accompanying costs have soared. Among the top ten medicines that are placing the biggest strain on the government's budget, six were only included in the reimbursement list since 2015, according to De Standaard.
The overall cost to the National Institute for Health and Disability Insurance (RIZIV) for all diseases combined has surged between 2014 and 2021 by a staggering €4 to €6 billion, and an additional €400 million between 2021 and 2023 alone.
An unhealthy burden
A meticulous analysis conducted by the CM Health Fund's research division revealed the extent to which public funds are channelled into pharmaceuticals. Notably, individual patient costs have remained relatively stable; however, the burden on the national treasury has multiplied. Medical expenses for those over the age of 65 now average around €2,000 annually: twice as much as in 2017.
Cancer treatments dominate the expenditure landscape, with the most costly drug being pembrolizumab, an immunotherapy for cancer, which consumed a staggering €160 million in the government's coffers last year, translating to roughly €3,000 per patient. Some of the priciest medications even reach an astonishing annual cost of nearly €500,000 per patient, although these are typically reserved for rare diseases affecting only a handful of individuals in Belgium.
The CM Health Fund has sounded the alarm on the escalating costs of medication. Luc Van Gorp, the chairman of the CM Health Fund, has urged a re-evaluation of the efficacy and value of drugs, emphasising the importance of considering post-treatment quality of life and life expectancy. "We must no longer view medication as a universal panacea," he told De Standaard. Van Gorp called for increased investments in prevention to reduce the risk of diseases like cancer, recognising the need to curb healthcare spending in an aging society.
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A notable revelation is that eight of the ten most expensive drugs are the result of "confidential contracts" between pharmaceutical companies and the government. The specific amounts paid by the government remain shrouded in secrecy. This scheme was introduced to expedite access to innovative medications, even before a clear understanding of their cost-effectiveness for patients was established.
While these contracts allow for discounts, they also create room for price discrepancies between European countries. Without transparency on pricing relative to neighbouring nations, Belgium remains limited in its negotiation leverage. Van Gorp underscored the necessity for more transparency in drug development and production costs and urged for price negotiations at the European level.
Interestingly, the practice of these "Maggie deals", which have drawn opposition criticism for years, has continued to rise under the tenure of Frank Vandenbroucke, the successor to former Health Minister Maggie De Block. Vandenbroucke asserts that these special agreements serve a purpose in addressing scientific and financial uncertainties while ensuring access to innovative treatments.
Nonetheless, he acknowledges the need for structural reforms in collaboration with international partners to strike a balance between the advantages of confidentiality and the disadvantages it poses to democracy and market functionality. The urgent need for reform is clear as the government grapples with mounting medicine expenses, threatening the stability of its healthcare system.
