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New convention for reimbursement of Gene Expression Profiling (GEP) tests in Belgium
In February 2023, the National Institute for Health and Disability Insurance (INAMI-RIZIV) announced the completion of a pilot project for gene expression profiling (GEP) tests in early-stage breast cancer, which ran from 2019. The pilot showed significant benefits, improving the quality of care and the quality of life for certain patients and personalizing the treatment.
Based on the pilot’s results, INAMI-RIZIV launched a new agreement called the ‘GEP convention,’ which has to be signed by a healthcare provider (breast clinic) who wishes to participate. Reimbursement via convention is limited to a maximum of 2,500 GEP tests per year.
Convention defines the brand-specific list of reimbursable tests (in Appendix 2). The test, the interpretation algorithm, and the laboratory where the test is performed must meet certain conditions.
The stakeholders (including the manufacturer or distributor of a commercial test) can submit an application to add a new GEP test to this list. The application procedure to add a new test to the list and specific conditions for the test are defined in Appendix 1 of the convention.
See full details here.
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