Stricter requirements to make cancer meds harder to get in Netherlands

Oncologists in the Netherlands will judge new cancer medicines more strictly before prescribing them to patients, according to new guidelines from the committee of Dutch oncologists and pulmonologists. In terminally ill patients with a life expectancy of a year or more, a drug must extend their life by at least four months instead of the current three months. Patient federations are livid, the Volkskrant reports.

Recent scientific research showed that many new, and often very expensive, medicines that came onto the market in recent years only extend the lives of cancer patients by an average of two to three months. Many of these drugs also have serious side effects.

Oncologists noticed the same in practice, and after a discussion, the professional groups for oncologists (NVMO) and pulmonologists who treat cancer patients (NVALT) voted to tighten the criteria.

Because of the stricter requirements, it is more likely that oncologists won’t prescribe new medicines. For medicines that can prevent cancer from returning after treatment, the pharmaceutical company will have to show that the medicine actually extends patients' lives. For medicine for terminally ill patients, if the patient’s life expectancy is at least one year, a drug must extend the patient’s life by at least 16 weeks instead of the current 12.

The Dutch Federation of Cancer Patient Organizations (NFK) is livid. “The Dutch practitioners leave patients out in the cold,” Pauline Evers of the NKF said. According to the federation, the adjusted criteria mean that patients in the Netherlands won’t have access to up to a quarter of the drugs approved by the EMA. “A worrying and unacceptably high percentage. This makes treatment out of reach for thousands of patients.”

According to the NFK, patients must be able to decide with their doctor whether a medicine is of added value to them. That can not be determined by the “cold figures” at the population level. A few months of life gain can sometimes mean everything to a patient, the NFK said. And there should be no selection criteria at that gate.

The interest group for pharmaceutical companies VIG is also less than enthusiastic about the new criteria. According to the VIG, patients in the Netherlands won’t get the same treatment options as patients elsewhere receive. “This puts the Dutch patient further behind European patients with the same form of cancer. That is inexplicable.”