PMU29 - EVALUATING BUDGET IMPACT ANALYSES FOR EXTRAMURAL DRUGS IN THE NETHERLANDS

Abstract

The Dutch National Health Care Institute determines and advises if health technologies are included in the mandatory basic care package. All new extramural drugs are assessed before they can be included in the basic care package - a budget impact analysis (BIA) is often part of this. The current evaluation was carried out to compare, for several drugs, the estimated budget impact with the realised budget impact to find out whether large discrepancies exist. Twelve extramural drugs that have entered the basic care package in the Netherlands between 2014 and 2016 were selected. For these drugs, BIA estimations (both the number of patients and costs) were compared with actual drug use (based on data from the Drug Information System of National Health Care Institute – GIP databank). Most BIAs made overestimations, with larger overestimations related to the costs than to the number of patients. On average, the number of patients turned out to be only 75% of what was estimated. For costs, this was only 50%. These overestimations may partly result from people starting to use the new drug later than expected. This may be caused by different factors, among which for example price negotiations. There were only 2 cases where more patients started using the new drug than anticipated. Most BIAs for new extramural drugs turned out to overestimate the number of patients that would start using the drug, and the total costs involved. The Dutch National Health Care Institute is taking this into account in order to improve the calculations and thereby produce more accurate BIAs. However, the current results should be interpreted with caution, as not all drugs that were included in the analyses reached their full potential yet (in terms of number of patients and total costs per year).