Permanent reimbursement for next-generation sequencing (NGS) in oncology launched in Belgium

Molecular biology tests by next-generation sequencing (NGS) in oncology and hemato-oncology have been temporarily reimbursed as a pilot in a limited number of centers under a specific agreement (Convention) with the National Institute for Health and Disability Insurance (INAMI/RIZIV) from July 2019 to June 30, 2024. 

On July 1, 2024, a new agreement (Convention) came into force, which allows permanent reimbursement via newly introduced Pseudo-nomenclature codes with fees. The pseudocode descriptions specify the indication, while certain biomarkers and reimbursement conditions are mentioned as notes to the code.

In addition to "classic" NGS, which allows the DNA sequence of genes or gene fragments to be determined, the agreement also allows reimbursement of "RNA-Seq" NGS for the analysis of genetic rearrangements and homologous recombination deficiency (HRD) test in combination with NGS in certain indications.

The pseudocodes (indications) with eligible biomarkers, reimbursement fees, and other conditions are determined in two lists (Annexes to the Convention) separately for solid tumors (28 codes) and malignant hematological diseases (23 codes). Some examples of new pseudocodes are provided below:

• 535010-535021 NGS for metastatic colorectal cancer;
• 535054-535065 NGS for squamous lung cancer;
• 535216-535220 RNA-Seq for diffuse glioma, circumscribed glioma, or ependymoma;
• 535570-535581 NGS for acute myeloblastic leukemia at diagnosis;
• 535614-535625 RNA-Seq for acute myeloblastic leukemia;
• 535975-535986 Screening for acquired chromosomal or genetic abnormalities (except rearrangement of immunoglobulin genes or T-cell receptor genes) using a molecular biology method: in the diagnostic investigation phase of acute myeloblastic leukemia or myelodysplastic syndrome with increased blasts (RAEB-2).

See the full details in French here.

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