The National Health Care Institute recommends including three new medicines against migraine in the basic health insurance package. These are three so-called CGRP inhibitors: erenumab, fremanezumab and galcanezumab. The inhibitors have been developed specifically against migraines and have a preventive effect.
The institute does set a number of conditions in the advice, which is addressed to the Minister of Medical Care. For example, only patients with chronic migraine (more than fifteen headache days per month) are eligible for reimbursement.
In addition, the two other treatment methods for migraine that are already reimbursed must prove ineffective for those patients and the medicines must be stopped in time if they do not work.
‘Huge improvement in quality of life’
There is about a 20 percent chance that the medicines will work, writes the Zorginstituut, which leads to a halving of the number of migraine days. “For those people, this means an enormous improvement in their quality of life,” according to the institute, which assesses the effect of new medicines and advises the government whether or not to include them in the basic package.
The inhibitors cost about 6000 euros per patient per year. The National Health Care Institute estimates that between 2,700 and 3,600 patients with chronic migraine are eligible for the drugs.
Reimbursement for very limited group
Headachenet, a network for people with migraines and other types of chronic headaches, responds “very critically” to the advice, especially the conditions.
According to the network, reimbursement for the “groundbreaking” drugs will become available to a “very limited group of migraine patients.” The patient organization wants the inhibitors to be reimbursed for everyone who has four or more migraine days a month.
The network also finds it “downright unethical” that patients with chronic migraine must first undergo the two other treatment methods before they are reimbursed for the inhibitors.
The Zorginstituut does not yet recommend including the medicines in the basic package for migraine patients with fewer than fourteen headache days per month, because no “research file” has yet been submitted for this group. “As soon as the pharmaceutical companies submit their application, the Zorginstituut can start an assessment,” the institute writes.
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