Proposition 55K0378

Projet de loi modifiant la loi relative à l'assurance obligatoire soins de santé et indemnités coordonnée le 14 juillet 1994, en ce qui concerne la création d'une commission de remboursement des produits et des prestations pharmaceutiques.

General information ¶

Authors

MR Caroline Taquin
Open Vld Robby De Caluwé, Goedele Liekens

Submission date

Sept. 17, 2019

Official page

Visit

Status

Adopted

Requirement

Simple

Subjects

medicinal product health policy health costs social security health insurance

Voting ¶

Voted to adopt

Groen CD&V Vooruit Ecolo LE PS | SP DéFI Open Vld N-VA LDD MR VB

Abstained from voting

PVDA | PTB

Contact form ¶

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Discussion ¶

Feb. 6, 2020 | Plenary session (Chamber of representatives)

Full source

I am referring to the written report.

Mr. Speaker, today we are voting here on a law establishing a committee for the refund of pharmaceutical products and benefits.

It is a new body, which must decide on the terms of reimbursement for, for example, probe feed or material for diabetics.

Today, the procedure is very complex and passing through the procedure takes a long time. It is therefore in the patient’s interest that the system works faster and more transparent.

On the program and in the law was also stated the composition of the committee that will determine the refunds.

It seems to us, first of all, very important that the parity composition is ⁇ ined, with the presence of insurance institutions defending the interests of patients in the broad sense of the word.

We are also very pleased that the PVDA proposal was approved by a very large majority. It also aimed to give patient associations a place and an advisory voice in the committee. Why is this important? Patient associations are well aware of the concrete needs and the difficulties experienced by patients with respect to the conditions of reimbursement. Let me give you the example of probe nutrition.

Today, there are serious shortcomings in reimbursement of probe feed. The Flemish Patients Platform pointed out that patients must pay large amounts and that there is no third-party payer scheme. I did this with a cancer patient. The firm refused to deliver the nutrition because the patient had no money to pay the large advance. He literally stood without food.

The Muco Association, which is the association of mucopatients, is currently sending that money to the patients themselves, in order to get the money back afterwards.

The patient associations also resent the large administrative burden and the absence of the inclusion of sonde feeding for adults, for example, in the maximum invoice.

With that example, I would like to indicate that the knowledge of the patient organisations is large. I therefore hope that their voice and their presence in the committee can contribute to making the concerns really heard.

Another problem that arises in the composition of the committee is that the industry is present there and that it has an advisory voting right. This presence and industry participation in a decision-making body is unacceptable for PTB. We have the same problem in parallel with the Drug Refund Commission where the presence of the industry weighs heavily on decisions. It is a direct and indirect pressure that is put on the participants and in their decision-making. This is denounced by many people.

Some have spoken of balance. As patients were introduced, the industry had to be preserved. There is no possible comparison. The financial weight, the weight of industry lobbying, obviously cannot be compared to the weight and voice of patients. For this reason, with our amendment, we propose to simply remove the presence of the industry in this committee. This will enable members of this committee to make their decisions objectively, without pressure from the industry and in the sole interest of patients and our social security.

With the abolition of the Technical Pharmaceutical Board, the Technical Board for Diagnostic Devices and Care Devices, which submitted proposals for the refund of the medical devices, as well as the Working Group for Medical Nutrition, which proposed the refund of medical nutrition, not only a administrative simplification but also a faster procedure is aimed. We can only welcome that.

Despite the fact that the bill had been prepared for fourteen months, it nevertheless reached the committee. That made it hard to work.

Since the bill makes the organization more workable and operating more efficiently and it benefits our people, we will support it.

I would like to congratulate Mrs. Dewulf for her maiden speech. (The applause)

Dear colleagues, if a government is in ongoing business, Parliament has a lot of freedoms. It is good that Parliament takes advantage of those freedoms and takes initiatives.

However, the Parliament also has responsibilities during this period. A minimum responsibility is to ensure that the public institutions can continue to work.

The proposal presented here is primarily a technical proposal that aims to remove a block in the Health Insurance Act. The legislative proposal establishes the Committee for the Reimbursement of Pharmaceutical Products and Benefits in order to avoid confusion with the existing Technical Pharmaceutical Board, given the differences in powers.

The Act containing various provisions of 22 June 2016 provided for the merger of the Technical Pharmaceutical Council, the Council proposing the nomenclature of medical services or, in professional terms, the magistral preparations, and the Technical Council for Diagnostic Devices and Care Devices, proposing the refund of medical devices, and the Medical Nutrition Working Group, proposing the refund of medical nutrition. The reason for combining the three services is mainly administrative simplification. Each decision of the three bodies had to be executed through a royal decree. This is often a very long procedure, while it usually involves adjusting limiting lists of additives such as those of, for example, a type of blood pressure meter and a medical food drink with a new flavor.

The patients know it is on the market and are waiting for their refund. Therefore, the RIZIV has begun to develop a procedure similar to the procedure of the CTG and the Commission addressing implants and invasive medical devices.

The Act of 22 June 2016 spoke of an extension of the powers of the Technical Pharmaceutical Council. But the RIZIV working group found that the use of the same name could lead to confusion. In order to avoid confusion about powers, they propose to rename this new committee to the Commission for the refund of pharmaceutical products and benefits. This name is more compatible with the other committees.

Therefore, it is a simple name change, which has already raised some questions. But that is actually unfair. As long as this law is not approved, the KB cannot be published and files remain with the RIZIV. In fact, the State Council no longer accepts the old procedure because the law provided that it would enter into force on 1 January 2020. I hope that everyone in this plenary session can support this proposal.

The latter is indeed the most important. Since 1 January 2020, there is now a gap and new funds cannot be reimbursed. For many patients, this is very important. This is about medical devices, medical nutrition, magistral preparations that must be made for a lot of patients, about capillary prostheses. It is important that patients who need this can also get these tools. The market is very innovative and very moving. As of January 1, 2020, this will no longer be possible for the new funds.

It is technical, but very important for patients. Therefore, we are pleased that we have been able to collaborate on this and that we have been able to add the representatives of the patients, with their advisory voice. We have done this together with the colleagues of the PS as sp.a.

I have another question for the Minister. It is of fundamental importance that we approve this law, but also that the KB for its implementation is handled quickly. These KBs deal with the household regulations and composition. The cabinet employee of the Minister has said that the KBs are ready. I hope that this is also the case and that they can be signed in the form of speech tomorrow. For example, the Technical Pharmaceutical Board, the equivalent of the CTG – the Pharmaceutical Compliance Commission – can start quickly and can provide patients with the resources they need and that are part of an accessible health care.

Thank you to all speakers.

The merger of three bodies into one advisory board will allow for more efficient managing of people and resources, especially because we often see the same people in different capacities.

With the addition of the patient organisations, the movement continues, involving them at an earlier stage in the policy, as they have already been incorporated into the Agency for Medicines and other bodies.

The Royal Decisions are indeed ready, Mr. Bertels. We will publish them with urgency, because the files are waiting. The Council of State accepts those submitted with the previous appointments, no longer.