Small-scale experiments ( Innovatie voor kleinschalige experimenten)
The Netherlands is known for its innovative spirit and its high-quality health care system. But how does the country support the development and implementation of new forms of care that can improve the lives of its citizens and reduce the costs and environmental impact of the health sector?
One of the ways is through the Small-scale experiments for the introduction of innovations (Innovatie voor kleinschalige experimenten) scheme, a subsidy scheme for promising care innovations that are not yet reimbursed by health insurers or the government. The scheme aims to stimulate the testing and evaluation of new care solutions in a real-world setting, involving care providers, patients, researchers, entrepreneurs and other stakeholders.
The scheme is managed by the Netherlands Organisation for Health Research and Development (ZonMw) and is part of the Mission-driven Top Sector and Innovation Policy, which focuses on four missions for health and care: 1) more years of healthy living; 2) better quality of life for people with chronic diseases; 3) better care and support for vulnerable groups; and 4) affordable and accessible care for everyone.
The scheme covers up to 80% of the eligible costs of the projects, such as personnel, materials, equipment, dissemination and evaluation. The maximum subsidy amount is €300,000 per project and the duration is up to 24 months. The projects are selected based on criteria such as relevance, feasibility, impact, scalability and sustainability.
Since its launch in 2020, the scheme has supported more than 50 projects in various domains of care, such as mental health, elderly care, chronic diseases, prevention and self-management. Some examples of successful projects that have received the subsidy are:
– A digital platform for self-management of chronic pain, which uses artificial intelligence and gamification to provide personalized coaching and feedback to patients, reducing their pain intensity and improving their quality of life.
– A virtual reality intervention for anxiety disorders, which uses immersive and interactive scenarios to expose patients to their fears and help them overcome them, reducing their anxiety symptoms and enhancing their coping skills.
– A smart sensor system for fall prevention, which uses wearable and environmental sensors to monitor the movements and activities of elderly people living alone, detecting falls and alerting caregivers, improving their safety and independence.
These and other projects show how the scheme is enabling the development and implementation of innovative care solutions that can benefit the health and well-being of the Dutch population and beyond.
Conditional funding of medical procedures (Voorwaardelijke toelating tot het basispakket)
The scheme in the Netherlands that is similar to the one in Switzerland is the Conditional funding of medical procedures (Voorwaardelijke toelating tot het basispakket), which is a pathway that allows the reimbursement of new medical procedures that have not yet been included in the basic health insurance package. The scheme aims to generate evidence on the effectiveness and cost-effectiveness of the procedures.
The scheme is open to manufacturers, providers, insurers, or other stakeholders who want to apply for the conditional funding of their procedure. The procedure must meet the following criteria:
- It must be a medical procedure, not a medical device or a drug
- It must have a CE mark or an approval from the Dutch Health Care Inspectorate
- It must have a potential to improve the quality of care and reduce the costs
- It must have insufficient evidence on its effectiveness and cost-effectiveness
- It must have a research protocol that meets the quality standards of the ZonMw
The scheme covers the costs of the procedure and the research, up to €10 million per project, and lasts up to four years. The projects are selected based on criteria such as relevance, feasibility, impact, scalability and sustainability.
You can find more information about the scheme, the application process and the selection criteria on the [ZonMw website]. You can also check out some examples of projects that have received the conditional funding in the past, such as a new treatment for chronic heart failure, a new technique for breast reconstruction, and a new method for diagnosing prostate cancer.
Conditional funding of medical procedures is a policy that allows certain drugs to be temporarily reimbursed by the basic health insurance in the Netherlands, under the condition that more evidence is collected on their effectiveness and appropriate use1. This policy is intended for drugs that treat serious, often rare diseases, for which no good alternative exists.
Some of the projects that are planned or ongoing for conditional funding of medical procedures in 2024 are:
- A project that evaluates the effectiveness and cost-effectiveness of nusinersen for the treatment of spinal muscular atrophy (SMA).
- A project that compares the effectiveness and cost-effectiveness of olaparib versus standard chemotherapy for the treatment of ovarian cancer
- A project that assesses the effectiveness and cost-effectiveness of tisagenlecleucel for the treatment of relapsed or refractory diffuse large B-cell lymphoma (DLBCL).
- A project that investigates the effectiveness and cost-effectiveness of voretigene neparvovec for the treatment of inherited retinal dystrophy caused by mutations in the RPE65 gene.
: Conditional inclusion of orphan drugs, conditionals and exceptionals in basic health care: [Nusinersen for spinal muscular atrophy]: [Olaparib for ovarian cancer] : [Tisagenlecleucel for diffuse large B-cell lymphoma] : [Voretigene neparvovec for inherited retinal dystrophy]
The Health Innovation Fund (Zorginnovatiefonds),
The Health Innovation Fund (Zorginnovatiefonds), which is a fund that invests in early-stage health start-ups that have a scalable and impactful solution for a health problem. The fund provides seed capital, ranging from €50,000 to €500,000, and coaching and mentoring.
Some of the companies that they have invested in or are planning to invest in 2024 are:
- Bloomlife: A company that develops a wearable device and app that tracks contractions and fetal heart rate during pregnancy.
- Caelus Health: A company that develops microbiome-based therapies for the prevention and treatment of metabolic diseases such as diabetes and obesity.
- Delft Imaging: A company that provides affordable and accessible diagnostic solutions for tuberculosis and other lung diseases, using artificial intelligence and cloud computing.
- Luscii: A company that offers a digital platform for remote monitoring and coaching of patients with chronic conditions such as heart failure and COPD.
- Nori Health: A company that creates a chatbot that helps people with inflammatory bowel disease (IBD) to improve their quality of life and self-management.