Change in reimbursement mechanism for diabetes devices in the Netherlands

In March 2020,  the Dutch Healthcare Institute (Zorginstituut Nederland, ZIN) advised the Ministry of Health, Welfare, and Sport to simplify the reimbursement for diabetes care aids covered by basic health insurance. Currently, the Real-Time Continuous Glucose Monitoring (RT-CGM) and ketone test strips are provided by the hospital as a part of medical specialist care (MSZ) and reimbursement via DRG system (DBC). However, insulin pumps, insulin pens, blood glucose meters, and Flash Glucose Monitoring are reimbursed by insurance companies as a part of medical aid care (HMZ).

In autumn 2019, the ZIN examined the existing medical aid care for people with diabetes in close collaboration with healthcare providers, patient associations, and health insurers. An important reason for this is notifications from patient associations and care providers that the current provision of diabetes aids through medical aids and specialist medical care leads to ambiguity and problems in practice. The ZIN observed problems arising when someone needs a combination of medical aids, one of which is reimbursed through specialist medical care and the other - through medical aid care. By arranging the provision and funding of aids for diabetes via a single way, it is expected that these reimbursement issues will no longer occur.

The new scheme is intended to take effect on 1 January 2021.

The full details in Dutch can be found here.

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