Frequently asked questions about the preference policy for medicines

Frequently asked questions

• Why is ONVZ switching to a preference policy for medicines?

  On 7 November 2023, the Dutch Trade and Industry Appeals Tribunal (CBb) ruled in the case between health insurer ONVZ and the Dutch Healthcare Authority (NZa). This ruling has far-reaching consequences for ONVZ and forces us to switch to a preference policy for medicines.

  For more information, read our 20 November news article (Dutch).

• What does the preference policy for medicines entail?

  ONVZ will designate one or a few specific medicines within most groups of interchangeable medicines* that is eligible for reimbursement. We call these designated medicines ‘preferred medicines’. It also means we will no longer cover other (brand-name) medicines in those groups, unless your doctor indicates it is medically necessary for you to use a specific brand-name medicine. The ‘List of preferred medicines’, which will be available on our website from 8 December, lists the medicines ONVZ will reimburse. If your (brand-name) medicine is not on the list, you may have to switch brands. 

  
  For the other groups of interchangeable medicines, we designate all unbranded medicines. We only cover brand-name medicines if your doctor indicates it is medically necessary for you to use that specific medicine.

  
  You do not pay any excess for medicines on the ‘List of preferred medicines’, but the excess does apply to the associated services provided by the pharmacy, such as the dispensation by and guidance on the use of the medicines.

  
  Your pharmacist knows which medicines ONVZ has designated as preferred, and will dispense these medicines to you.

  
  *Interchangeable medicines are different medicines with the same active ingredient, dosage and route of administration.

• Will my medicine still be reimbursed by ONVZ?

  Within most groups of interchangeable medicines, ONVZ has designated one or a few specific medicines as preferred medicines. These can be found on the 'List of preferred medicines', available from 8 December. If your (brand-name) medicine is not on the list, you may have to switch brands.

  
  For the other groups of interchangeable medicines, we designate all unbranded medicines. We only cover brand-name medicines if your doctor indicates it is medically necessary for you to use that specific medicine.

• What if my medicine is no longer covered?

  Is your (brand-name) medicine not included in our preference policy? And is it not medically necessary according to your doctor that you that a specific (brand-name) medicine? Your pharmacy will give you a different medicine with the same active ingredient, dosage and administration route.

  
  Your pharmacist knows which medicines ONVZ has designated as preferred, and will dispense these medicines to you.

  
  If you still want to continue using the brand-name medicine, you can. However, you will have to pay the full price yourself.

• Can I still choose to use a brand-name medicine?

  Is your (brand-name) medicine not included in our preference policy? And is it not medically necessary according to your doctor that you that a specific (brand-name) medicine? You can still opt to use this brand-name medicine, but you will have to pay for it yourself. This medicine will no longer be reimbursed by ONVZ.

• How does ONVZ guarantee the safety and availability of designated medicines?

  Quality, safety and efficacy are paramount in the selection of medicines to be included on the list of ‘preferred medicines’. The designated medicines are included in the Medicine Reimbursement System (GVS). All medicines included in the GVS have been evaluated on their therapeutic value and effectiveness. This means that they are of high quality and have been checked for safety and efficacy by the Medicines Evaluation Board (CBG). We make agreements with manufacturers to guarantee availability.

• Will the preference policy for medicines affect the premium?

  The premium for 2024 has already been set. The switch to a preferred medicine policy is likely to result in lower costs in 2024. ONVZ is a not-for-profit organisation, so if we have money left over, it will be invested in next year's premium, go to healthcare or we will use it to maintain our own capital.