Integrated Value-based Assessments of Screening and Expensive Treatments; a focus on health-economic aspects

Global health costs have been rising for years with an annual growth rate of approximately 8%. This trend also applies to the Netherlands, where the increase in healthcare expenses continues to escalate. The costs of the basic health insurance package increased by 2.9% in 2022, reaching a total of €51.3 billion. This increase is partly due to the inclusion of new expensive medications in the Dutch health insurance. Projections indicate that future population aging and the influx of pricey medications could trigger exponential cost spikes and strain healthcare accessibility.
The thesis presents measures to manage the cost increase and maintain accessibility to healthcare. Part 1 focuses on preventive measures for conditions reliant on costly medications such as Hepatitis C (HCV) and lung cancer. Early detection of HCV in migrants and pregnant women proves cost-effective, particularly through targeted screening of at-risk groups and potentially monitoring asymptomatic patients. Similarly, lung cancer screening demonstrates cost-effectiveness across various age groups of smokers and ex-smokers. Implementing screening programs for HCV and lung cancer in specific populations could reduce expenditure on expensive medications while concurrently enhancing health outcomes.
Part 2 focuses on the current system of approval and reimbursement of expensive medicines, introducing value-based pricing as a potential solution. This approach integrates real-world data with clinical trial-data to gauge the value and costs of medications more accurately. It holds promise for transparent pricing and enhanced accessibility to expensive drugs, contingent on collaborative efforts among hospitals, health insurers, manufacturers, and the Ministry of Health, Welfare, and Sport.