BMI View: The healthcare market in the Netherlands will continue to offer considerable commercial opportunities. As a part of the Health Insurance Act, implemented in 2006, private insurance for curative care and supplemental benefits is mandatory for the entire population. However, the Act is based on the principles of managed competition: insurers and providers of care compete on price and quality while the government has set certain rules to guarantee universal access to good-quality care - creating a highly competitive business environment and acting as a challenge to company revenue streams.
Headline Expenditure Projections
Pharmaceuticals: EUR5.92bn (USD7.93bn) in 2014 to EUR5.85bn (USD6.43bn) in 2015; -1.2% in local currency terms and -18.9% in US dollar terms. Forecast in line with last quarter.
Healthcare: EUR73.31bn (USD98.23bn) in 2014 to EUR74.73bn (USD82.20bn) in 2015; +1.9% in local currency terms and -16.3% in US dollar terms. Forecast revised upwards from last quarter due to the release of WHO confirmed data.
The Netherlands continues to rank in the lower half of BMI's Risk/Reward Index (RRI) for the 15 key Western European markets, ranking 11th in our ratings for Q315. The country has moved up a position from last quarter. At 64.7, its overall RRI score remains only slightly below the regional average of 66.8. While the country offers drugmakers a relatively low-risk operating environment, poor market prospects - due to pressures on pricing and reimbursement and the market's maturity - will continue to weigh down the country's overall standing.
Key Trends And Developments
The Netherlands' Medicines Evaluation Board (MEB) has suspended the marketing authorisations for the generic medicinal products irbesartan torrent and irbesartan hydrochlorothiazide torrent. These products are currently not available in the market. According to the MEB, the trial that served as the basis of admission for the products was not properly carried out by India-based GVK Biosciences. In addition, the marketing authorisation holder has submitted inadequate evidence to support the bioequivalence of these generic medicinal products with the branded medicinal products, the board found.
The Netherlands MEB has also issued conditional marketing authorisation for the medicinal product Thiosix (tioguanine). The product can be used in the treatment of patients who respond insufficiently to regular medication for inflammatory bowel disease such as Crohn's disease and ulcerative colitis. 'By authorising this new indication, the MEB is providing an impetus for drug rediscovery. This decision allows us to continue monitoring this medicinal product for quality, efficacy and risks,' the MEB Chairman Bert Leufkens said (Press Release). Previously, tioguanine has been used for decades as an active substance in a medicinal product for the treatment of leukaemia.
Mylan has successfully completed its acquisition of Abbott Laboratories' non-US developed markets specialty and branded generics business. Abbott announced in July 2014 that it was to sell its developed market branded generics business to Mylan for equity ownership of a newly formed entity, Mylan NV, that will combine Mylan's existing business and Abbott's developed markets pharmaceuticals business. The entity will be organised in the Netherlands and will be publicly traded.
BMI Economic View
The Netherlands will remain on a slow and steady growth trajectory over the next two years. A nascent recovery in the housing market will provide some relief to consumers, but household indebtedness is still among the highest in the eurozone.
BMI Political View
The Dutch grand-coalition government and its favoured opposition parties lost their majority in the upper house following provincial elections on March 18. This will result in a period of legislative deadlock and will raise the probability that the government stands down before the end of its mandate in 2017.