Stem cell transplant for a select group of MS patients in the basic package

Reimbursement of costs associated with relevant maintenance agreements

From now on, stem cell transplantation falls under the basic insurance of health insurers for a certain group of MS patients. These are MS patients with the RRMS variant where the disease is very active, the most effective drug is not working and it gets worse in a short time.

In RRMS, episodes of the disease alternate with periods of recovery. Depending on the severity of the disease, attacks are treated with a combination of drugs. This combined treatment approach is highly effective and relieves the disease in more than 95 percent of all patients. In a small proportion of patients, the drug is insufficiently effective and the disease remains very active. They deteriorate rapidly in a short period of time. According to the Zorginstituut, stem cell transplantation is a proven effective treatment for these patients. It affects 10 to 20 patients per year. The refund is valid from December 12, 2022.

“Good news for MS patients due to Health Institute decision”

Practitioners recognize themselves in the perspective of the Zorginstituut. Neurologist Joep Killestein of the Dutch Association of Neurology (NVN): “The decision of the Health Institute is good news for people with MS. Together with the Patient Association, NVN is committed to reimbursement of this treatment in the Netherlands. We believe that stem cell transplantation is an effective treatment and can provide a solution for patients who have failed to respond to highly effective MS drugs. Although this concerns a small group of patients who are eligible for stem cell transplantation, it is an important decision for this group to which this treatment now belongs and is also reimbursed in the Netherlands.

Disruption and reconstruction of the immune system

Stem cell transplant (AHSCT) is an intensive form of immunotherapy aimed at disrupting and rebuilding the immune system. Stem cells are taken from the patient’s blood and then the immune system is destroyed by chemo-immunotherapy. Then the patient’s own stem cells are replaced. Fewer attacks are seen in patients after stem cell transplantation. In addition, scientific evidence shows that fewer patients become less functional. Patients report a better quality of life.

The result of the treatment outweighs any serious side effects

Stem cell transplant can cause serious side effects, such as high fever and infection, because the immune system is destroyed. Then there is no resistance. Based on the studies studied, the Zorginstituut concludes that the beneficial effects of stem cell transplantation for this specific patient group sufficiently outweigh the risks of the treatment.

Quality agreements must ensure due diligence

The Healthcare Institute has asked healthcare professionals and the Patient Association to make and record quality agreements in order to guarantee adequate care. The agreements are as follows:

  • Stem cell transplantation for highly active RRMS is performed in two hospitals: UMC Amsterdam and St. Antonius hospital.
  • A central committee will be set up to decide whether a patient meets the criteria for stem cell transplantation. This also applies to healthcare professionals, including neurologists, a hematologist, and a neuroradiologist.
  • Patients are well and thoroughly informed about the treatment and the expected results and side effects, so that they decide together with their doctor whether or not to undergo the treatment.
  • Patients are followed for a minimum of 5 years, during which time the effect of stem cell transplantation is recorded and evaluated.
  • Author: Frances Van Dalen
  • Source: Gezondheids Net

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