# Hermans keeps Enhertu and Skyclarys out of basic insurance

> Health minister Sophie Hermans says Enhertu for metastatic gastric cancer and Skyclarys for Friedreich's ataxia will stay out of the basic health insurance package for now, because talks with the manufacturers did not produce an acceptable price.

Society · published 2026-11-05 19:13 · https://nlnow.nl/a/basic-insurance-won-t-cover-gastric-cancer-drug-enhertu/

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.

## Background

- **basispakket**: The basic health insurance package is the set of care and medicines that everyone in the Netherlands is required to have covered by their basic health insurance (basisverzekering). Only care and medicines included in this package are reimbursed under that basic policy, so a treatment left out of it is not covered by basic insurance. Which treatments are included is set by the Dutch government and decided on by the Zorginstituut.
- **Zorginstituut**: The Zorginstituut is the independent Dutch public body (Zorginstituut Nederland) that decides which care and medicines are included in the basispakket. It assesses whether treatments are effective and whether their price is reasonable, and it negotiates reimbursement with suppliers of medicines on behalf of the Dutch state.

From NLnow, news from the Netherlands in English. How stories are made: https://nlnow.nl/about/