Possibly two new waste medicines in the basic package: you must meet these requirements to be eligible

Two new weight-loss medications may soon be added to the basic health insurance package. The Dutch Healthcare Institute will assess whether the medications Wegovy and Moujanro will also be covered. To be eligible, however, you must meet several specific requirements.

There are already two waste medicines offered in the basic package in the Netherlands, namely Saxenda and Msymbia, but two more waste medicines may be added in the future.

Only severely overweight people are currently eligible for reimbursement from their health insurance for Wegovy and Mounjaro . This applies to people with a Body Mass Index of 30 or higher and associated conditions, such as chronic kidney failure, heart failure, and sleep apnea. People with a BMI over 35 are also eligible for reimbursement. According to the National Health Care Institute (Zorginstituut), this represents a "very large group of patients, estimated at over 1 million people."

When assessing waste medicines, the healthcare institute will initially only look at effectiveness and health benefits for the two patient groups mentioned above, because the most evidence is available for them that the medicines can improve their health.

The decision to initially assess the drugs only for these groups also receives support from healthcare professionals, patients, and health insurers, who have contributed to the discussion. Use of the drugs should be combined with a lifestyle intervention, which also addresses factors such as stress, sleep, nutrition, and exercise.

Remarkably, in 2024, the Dutch Healthcare Institute issued a negative recommendation regarding reimbursement for the drug Wegovy. While it was already clear at the time that the drug leads to weight loss, much remained unclear about its side effects, long-term effects, and how people can reduce their use responsibly. Furthermore, it was impossible to assess whether the health benefits outweighed the costs of treatment with the drug and for which patients the drug would lead to health improvements.

Previous studies have shown that patients taking Wegovy or Mounjaro regain weight after stopping the medication. This would mean patients would have to take the weight-loss medication for the rest of their lives, costing between €250 and €450 per month.

The healthcare institute will begin its assessment later this year. It will certainly take several months before the recommendations are available, a spokesperson said. After that, it will be up to the Minister of Health, Welfare and Sport to decide whether the medications will actually be added to the basic health insurance package.

Another weight-loss drug being hailed as a breakthrough against obesity is Ozempic. But is it a weight-loss drug or a symptom-relieving drug? Read more about the downsides of this drug here.

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