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Belgium

Reimbursement of anti-dementia drugs

The availability of medicines in general

In Belgium, the reimbursement system has classified drugs into different reimbursement categories.

  • Medicines in category A for serious illnesses are fully covered by the system and free of charge for the patient.
  • For medicines in category B (useful drugs), the patient is required to pay 25% up to a ceiling of € 10.20.
  • For medicines in category C (less useful drugs), the patient is required to pay 50% up to a ceiling of € 17.00. This percentage may go up to 60% or 80% for drugs certain medicines in this group which fall under category CS (ease drugs) or Cx (for example: contraceptives).

For medicines for which an identical generic product exists, the refund by the reimbursement system is reduced by 30%. [1]

The availability of Alzheimer treatments

All four anti-dementia drugs are available to patients in Belgium and are part of the reimbursement system.

Belgium has a very strict treatment protocol for drugs to be reimbursed. Amongst others, it limits the prescription of anti-dementia drugs to specialist doctors, both for treatment initiation and for treatment continuation. An MMSE score of between 24-12 is required for the reimbursement of acetylcholinesterase inhibitors and a score of between 15 and 3 for the reimbursement of memantine.

The Belgian system explicitly limits reimbursement to one class of drugs only, so that patients would not be able to receive bi-therapy under the system unlike some other European countries. According to the Ligue Alzheimer, a significant number of patients and carers have to pay for their Alzheimer medicines, because their general practitioners failed to refer them to a specialist.

The reimbursement system does not impose any restrictions for the reimbursement of people living alone or in nursing homes.

 

Donepezil

Rivastigmine

Galantamine

Memantine

Reimbursement

Yes

Yes

Yes

Yes

Initial treatment decision

Specialist doctors

Specialist doctors

Specialist doctors

Specialist doctors

Continuing treatment decision

Specialist doctors

Specialist doctors

Specialist doctors

Specialist doctors

Required examinations

Diagnostic protocol

Diagnostic protocol

Diagnostic protocol

Diagnostic protocol

MMSE limits

24-12

24-12

24-12

15-3

People living alone

No restrictions

No restrictions

No restrictions

No restrictions

People in nursing homes

No restrictions

No restrictions

No restrictions

No restrictions

[1] European Commission (2006): MISSOC – Mutual information system on social protection : Social protection in the Member States of the European Union, of the European Economic Area and in Switzerland : Comparative tables

 

 
 

Last Updated: mercredi 15 juillet 2009

 

 
 

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