Biomedical Engineering Reference
In-Depth Information
health-care insurance companies label the individual as noncompliant and
refuse health-care support? These questions need to be considered in public
and policy debates, which are ongoing anyhow.
12.3.3.8 Modes of Reimbursement
In the Netherlands, health-care insurance companies are obliged to provide
a statutory basic health-care policy to all Dutch citizens, the content of which
is determined under the supervision of the Dutch Health Care Insurance
Board (CVZ).* For medical services to be taken up in the basic health-care
insurance policy, the CVZ will look at several issues such as the urgency in
need, the effectiveness in terms of fulfilling the promise (evidence-based),
and the cost-effectiveness (in terms of balance between costs and benefits).
For the applications of BAN being developed for monitoring purposes, it
is unclear how urgent and effective such applications are and will be. Our
interviews suggest that actors in the innovation chain of the health-care col-
lectively agree that there is a clear need for more and stronger cooperation
between medical education institutes with scientific and industrial com-
munity to determine the usability and effectiveness of different envisioned
applications of BAN already in early stages of development. The main argu-
ment that was mentioned frequently in our interviews was that early cooper-
ation between health-care professionals and scientific/industrial community
who are developing such applications can lead to a better assessment of the
evidence for the functioning and benefits of specific devices.
Early cooperation between the medical community (e.g., academic insti-
tutions for primary health care) and the medical devices industry could
also function as a productive strategy to ensure funding schemes in the
future. Added value in terms of quality of life is an important requirement
in reimbursement decision making. Almost all our interviewees who were
involved in the development of BAN concepts mentioned to face challenges
with regard to proving the added value of devices in terms of quality of
life. In our interviews with medical education institutes, it became clear that
there are various methods available on the table to tackle such challenges.
However, due to limited interaction, such methods were never applied. This
point makes the early cooperation with medical institutions to be consid-
ered seriously. The argument is that if devices have been proven to work
on the basis of medical studies, the medical community and the industry
can then approach health-care insurers to adopt these technologies in their
policies. Adopting proven services would bring added value to the clients of
*
The CVZ coordinates the implementation and funding of the Cure Insurance Act (Zvw) and
the Exceptional Medical Expenses Act (AWBZ). The CVZ adopts an independent position: in
between policy and practice on the one hand, and in between the central government and the
health insurers, care providers, and citizens on the other (http://www.cvz.nl/english).
