The practice that lung patients are forced to change medication because it suits the health insurer financially is being curbed. The Longfonds has concluded an agreement with, among others, the sector organizations of health insurers, pharmacists and general practitioners.
The agreement must ensure that the 1.2 million lung patients do not have to switch unnecessarily from inhaled medication. That still happens now and it is not uncommon for them to suffer from nasty side effects.
Lung patient Maria Toren-Ronchetti, for example, gets epileptic seizures if she doesn’t get exactly the right medication:
Representative research by the scientific institute Nivel shows that last year more than 40 percent of lung patients had to switch to another medicine. In total, almost half of those medication switches had a non-medical reason, such as the insurer’s preferential policy (25 percent) or medicine shortages (23 percent).
The most important non-medical reason for switching – the insurer no longer reimburses the drug – should be a thing of the past with this agreement. Health insurers will soon be allowed to transfer a lung patient to another drug only once every four years on the basis of their preferential policy. But if the doctor indicates that there may not be a change at all due to medical necessity, then it should not happen.
Good guidance
If changes do have to take place, for example in the event of a shortage of a medicine, patients must be properly supervised by pharmacists and general practitioners.
“And I think that point is a real breakthrough,” says Michael Rutgers, director of the Long Fund. “It still regularly happens that people receive a bag of medication without proper instructions. Things can go really wrong because people use their medication incorrectly after a medication change. Agreements have now also been made about this.”
Rutgers acknowledges that this agreement does not solve the drug shortages. “You can’t just arrange that for lung medication, you have to solve that for medicines in general.”
Netherlands in the back row
And that is not easy. Raw materials and medicines are made by a small group of factories in low-wage countries such as China and India. One production error in one factory can lead to a chain reaction in the logistics chain, resulting in a worldwide shortage.
But in the Netherlands that shortage usually lasts longer than in neighboring countries. Pharmaceutical companies earn less money in the Netherlands due to the effective preferential policy (preference policy) of the health insurers. After all, this policy pushes down the prices of medicines. This makes the Netherlands an unattractive country to do business with. So when the scarce medicines are available again, these resources first go to countries where people pay more than in the Netherlands.
At the beginning of this year, wholesalers are obliged to hold so-called iron stocks. There should be at least a month’s buffer. But according to the trade association of wholesalers, nothing has yet come of that iron stock. The parties involved and the Ministry of Health have not yet agreed on who should bear the costs of these large supplies. There should be more clarity about this this fall.
Longfonds keeps an eye on parties
Doctors and pharmacists have been arguing for some time that health insurers make their preference policies less rigid. Then the Netherlands would spend less time in the queue and the consequences of shortages would be felt less extreme by patients.
Perhaps the new agreement is already having this effect for lung patients in the Netherlands. “Certainly because they have to be better guided if they do have to switch,” says Rutgers. “We will therefore keep a close eye on whether that actually happens. We also have a reporting point for this. An agreement is one thing, actually implementing it is point two.”
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