Hermans keeps Enhertu and Skyclarys out of basic insurance

Two medicines will not be reimbursed from the basic health insurance package (basispakket) for now: Enhertu, for patients with advanced or metastatic gastric cancer, and Skyclarys, for the rare muscle disease Friedreich's ataxia. Negotiations with the suppliers did not produce a price that society could accept, the government says. It was following advice from the Zorginstituut, the national health care institute.

The Zorginstituut sees added value in both medicines but considers the price too high. It advised a price cut of 84% for Skyclarys and of more than 62% for Enhertu in gastric cancer.

At the public list price, Skyclarys costs more than €245,000 per patient per year. It can slow the decline of the disease but not stop it. Enhertu extends average survival in gastric cancer by more than four months compared with chemotherapy.

I understand very well that the decision is drastic for patients who hoped for a new treatment. But I cannot accept new medicines at any price.Health minister Sophie Hermans

Hermans says she did her utmost to reach a deal. Her task, she says, is to spend the available care money as fairly and effectively as possible for all patients in the Netherlands.

The door remains open. The minister will consider reimbursement if the suppliers still agree an acceptable price, or if new data lead to revised advice. Enhertu remains reimbursed for patients with HER2-positive breast cancer until 1 January 2028, after which the contract must be renewed.