Ministers confirms two new cancer drugs will not be covered by basic health insurance

The drug Enhertu will not be included in the basic health insurance package to help patients with metastatic stomach cancer. Negotiations with the manufacturers over the drug’s price have failed to produce a sufficient agreement, Health Minister Sophie Hermans wrote in a letter to the Tweede Kamer. The drug Skyclarys will also not be included in the basic insurance package.

Although Enhertu does not cure cancer, it can extend the final stages of life for patients with metastatic breast cancer. The drug was already covered under the basic health insurance for women with HER2-positive breast cancer and will remain available to them until 2028.

According to an assessment by the National Health Care Institute, the drug can provide patients with approximately four additional months of life compared with chemotherapy. The assessment also concluded that the drug could be included in the basic insurance package for metastatic stomach cance, but only if its price were reduced by 62 percent.

The drug Skyclarys will also not be included in the basic insurance package. It is used to treat people with Friedreich’s ataxia, a rare neuromuscular disorder that causes impaired coordination and movement. According to the National Health Care Institute, its price would have needed to decrease by 84 percent for the drug to qualify for coverage.

Manufacturer Biogen has expressed disappointment, arguing that decisions should take factors beyond cost into consideration. The company also stated that it was willing to offer a "substantial discount.” There are approximately 160 people living with Friedreich’s ataxia in the Netherlands.

“I fully understand that the decision not to include these drugs in the covered healthcare package has a significant impact on patients who hoped for access to a new treatment,” Hermans states. “That is why I have made every possible effort to reach an agreement with the manufacturers. However, I cannot approve new physicians at any price. As Minister of Health, it is my responsibility to ensure that the available healthcare budget is allocated as fairly and effectively as possible to benefit all patients in the Netherlands.”