Decision making in drug reimbursement

Life expectancy is increasing in the Organisation for Economic Co-operation and Development (OECD) countries. Simultaneously, however, many countries have experienced rising health care expenditure, albeit at a reduced rate during the last years due to the global economic recession. For instance, health care expenditure in The Netherlands has increased from 6.5 billion to 46.9 billion and 94.2 billion euro in 1972, 2000 and 2013, respectively.4 More apprehensively, not only absolute expenditure but also the relative share of Gross Domestic Product (GDP) spent on health care has increased across OECD countries. For example, the Dutch share of GDP spent on health care increased from 8.7%, to 11.2%, and 15.6% in 1972, 2000, and 2013, respectively.