Medical Device Reimbursement in the Netherlands

Reimbursement Landscape in the Netherlands

The purpose of this step is to understand the current reimbursement environment in the Netherlands, relevant for your medical device. To do so, we will:

• Clarify relevant coding systems, including the Dutch Healthcare Authority’s (Nederlandse Zorgautoriteit) Policy for the Performance and Tariffs for Specialist Medical Care and the DOT case mix system. Identify coverage policies under the mandatory national health insurance scheme (Zorgverzekeringswet, Zvw) and supplementary benefits packages, including assigned payment rates for the device or comparable products.
• Locate any specific reimbursement mechanisms available to the device, or recommend if new mechanisms are needed (e.g., DOT adjustment, conditional reimbursement, pilot project applications).
• Identify main decision makers, outline the typical reimbursement path, milestones, and timelines, and provide an initial reimbursement strategy for the device in the Netherlands.

Reimbursement Planning for Dutch Decision Makers

Based on the Reimbursement Landscape, we plan the development of evidence for Dutch decision makers, including the Ministry of Health, Welfare and Sport (VWS), NZa, ZN, and ZonMw. This includes:

• Value Story: Clinical and economic benefits from the perspective of healthcare providers and insurers, serving as the basis for the economic model.
• Economic Model: Economic impact analysis identifying outcomes data for reimbursement submissions and clinical studies.
• Clinical Data: Guidance for clinical studies to generate required reimbursement evidence.
• Decision Makers’ Feedback: Interviews with Dutch stakeholders using Mediclever’s local network to validate value story, economic model, and study design.

Implementation

Depending on existing reimbursement mechanisms, we conduct:

• Billing Guide: Instructions for physicians and healthcare providers to obtain reimbursement.
• Reimbursement Applications: Applications to NZa or inclusion in DOT system or Specialist Care Tariffs.
• Pilot Projects: Collaboration with providers and insurers for up to 3-year innovation projects under NZa policies.
• Other Funding Options: HTAs from iMTA or conditional reimbursement applications with Ministry approval.

Benefits of Partnering with Mediclever

Working with Mediclever ensures a smooth and structured approach to reimbursement in the Netherlands. Our clients gain:

• Faster Market Access: Streamlined reimbursement pathways, reducing delays and uncertainty.
• Strategic Insights: Tailored advice based on Dutch NZa policies, DOT case mix codes, and insurance schemes.
• Evidence-Based Support: Value story development, economic modeling, and clinical data guidance to strengthen reimbursement submissions.
• Local Expertise: Direct engagement with Dutch decision makers and payers for actionable feedback and guidance.
• End-to-End Assistance: From reimbursement landscape assessment to implementation, pilot projects, and billing guidance.

Key Questions About Medical Device Reimbursement in the Netherlands

How long does medical device reimbursement take in the Netherlands?

Timelines depend on the type of reimbursement pathway. National processes typically take several months, while pilot projects can take up to 3 years.

Which reimbursement pathways exist for medical devices in the Netherlands?

Funding may come via NZa policies, DOT case mix payments, Zvw coverage, supplementary benefits packages, conditional reimbursement, or pilot projects.

What coding systems are relevant for reimbursement in the Netherlands?

Reimbursement relies on DOT case mix codes, NZa tariffs, and coverage specifications for mandatory or supplementary insurance.

Who are the key decision makers for reimbursement in the Netherlands?

Ministry of Health, Welfare and Sport (VWS), NZa, ZN, ZonMw, and hospital/insurer representatives.

Can reimbursement planning begin before regulatory approval?

Yes. Early planning informs evidence generation, economic modeling, and pilot project design, though formal reimbursement requires regulatory approval.

View all medical device reimbursement and market access FAQs, or explore our medical device reimbursement consulting services.

Why Mediclever for Medical Device Reimbursement in the Netherlands?

Mediclever specializes in Dutch medical device reimbursement, combining local expertise with structured reimbursement strategies across Zvw, supplementary insurance, DOT, and NZa pathways.

We support manufacturers with landscape assessments, evidence generation, economic modeling, and coding analysis to facilitate market access and reimbursement in the Netherlands.