"An active involvement of health care professionals, patients, researchers and healthcare decision-makers is essential in HTA research to identify priorities, perform high quality HTA and facilitate implementation".
– Mr. Henk J. Smid, Director, ZonMw
History and Structure
In 2001 the Health Research and Development Council and the Council for Medical and Health Research from the Netherlands Organisation for Scientific Research have integrated to form a new organisation: the Netherlands Organisation for Health Research and Development ZonMw. With a range of grant programmes, ZonMw stimulates the entire innovation cycle, from fundamental research to the implementation of new treatments, preventive interventions and improvements to the structure of healthcare. ZonMw is an intermediary between research, policy and practice.
Progress requires research and development. ZonMw funds health research and stimulates use of the knowledge developed to help improve health and healthcare in the Netherlands. ZonMw’s main commissioning organisations are the Ministry of Health, Welfare and Sport and the Netherlands Organisation for Scientific Research. In our view, two things are needed to improve health and healthcare in the Netherlands: knowledge, and actual use of knowledge. In selecting grant proposals, ZonMw always looks for a combination of innovation and quality, since this is the only way to deal with the complex challenges we face in society today, and to ensure that clients receive affordable care of a high standard. ZonMw always strives for the best result.
How ZonMw Works
HTA is key in several ZonMw programs, the most important being:
Decision-makers in the world of politics and health care practice have to carefully weigh up the costs and effects of interventions. The Health Care Efficiency Research programme provides the knowledge needed to make those decisions. It helps providing an evidence base for innovative interventions so they can be introduced, and it helps ensuring that inefficient interventions are no longer applied in health care practice. In this way, we work with researchers, patients, practitioners and policymakers to achieve good, affordable care. The programme has two lines of research. The first involves open calls for studies designed to address efficiency issues in health care practice. The other line involves targeted calls for studies designed to address efficiency issues that come from policy parties in order to stimulate health care innovation, and to respond flexibly to new developments. The targeted call allows scope for research linked to conditional inclusion/funding by the Health Care Insurance Board (National Health Care Institute). Health care that is funded from the basic insurance package must be ‘state of the art in terms of scientific knowledge and practice’. An intervention may be granted a temporary exemption from this criterion, and be conditionally included in the basic package for a period of four years. Any missing data must be gathered over this four-year period.
In 2012 the Dutch Ministry of Health has provided funding to address gaps in society’s knowledge about how to optimally use pharmacotherapy. The Rational Pharmacotherapy programme aims at optimising effective, safe and efficient use of existing medicines (i.e. pharmacological treatments authorised for the Dutch market). Questions concerning the use of medication in daily practice are a central theme. Pre-registration drug development research cannot be financed by this programme.
The programme has open calls for studies designed towards different aspects of pharmacotherapy including (cost-)efficiency, compliance, polypharmacy and new indications. The programme also helps the start-up of registries that focus on pharmacotherapy in daily practice. These registries provide healthcare professionals with feedback information and collect data for research towards rational pharmacotherapy. The Rational Pharmacotherapy programme has been setup to receive funding for an extensive period of time.
From 2006-2012, ZonMw has funded research to establish the effectiveness of new expensive medicines or orphan drugs. These drugs were, at the start of the research, temporarily reimbursed by the Dutch Health Care Insurance Board (College voor Zorgverzekeringen) under the policy guideline for high-cost medicines. The results of the projects contributed to the reimbursement dossiers with information on the safety and (cost)effectiveness of the drug. The dossiers are used by the Dutch Health Care Insurance Board to make a balanced decision whether to continue the reimbursement of the drug or not. In total 22 projects received funding. The specific funding connected to the reimbursement of drugs has stopped. The projects are now part of the Rational Pharmacotherapy program.
Another part of the High Cost Medicines Efficiency Studies Programme involves the development and optimalization of Health Technology Assessment methodology which can be used in the research into drug (cost)effectiveness or in the decision making process on the reimbursement of (expensive or orphan) medicines. A total of 53 projects have been granted, no further funding is available. For more information on the development of HTA methodology for policy decisions, see http://www.zonmw.nl/fileadmin/documenten/DO_Farmacotherapie_Dure_Weesgeneesmiddelen/Developing_new_HTAmethodology_SMDM_DEF.pdf
For the granted projects (in Dutch, with a summary in English), see: www.zonmw.nl/nl/programmas/programma-detail/doelmatigheidsonderzoek-farmacotherapie/projecten/
The ultimate value of practice oriented scientific research becomes apparent when the results are incorporated in clinical practice or health care policy. The HTA programmes, therefore, focus on dissemination and implementation of results. Dissemination activities include the publications of annual reports, TA-reports and research findings through various media, newsletters, website and peer-reviewed literature. There is an active policy to achieve implementation of the results of the projects. The importance of implementation is recognized both on the level of the programme as on the level of the separate projects.
The Dutch Order of Medical Specialists together with scientific organisations of the medical specialty societies and ZonMw have started the Verstandig Kiezen Campaign (http://www.zonmw.nl/nl/themas/thema-detail/doelmatigheid/verstandig-kiezen/) which is based on the American Choosing Wisely (http://www.choosingwisely.org/). Results from the ZonMw HTA programmes facilitate choices for the most effective and cost-effective options for patient care.
- Overview HTA methodology studies (in English)
- Developing new HTA Methodology for Policy Decisions (in English)
- Beter af met DoelmatigheidsOnderzoek (in Dutch)
- ‘Kostenbesparingen door onderzoek en innovatie in de zorg’- Zorgmarktadvies (October 2013, in Dutch)
Projects can be searched through the ZonMw website. Most projects have a summary in English.
Both the Health Care Efficiency Research Programme and the Rational Pharmacotherapy Programme are intensifying their relationship with the different stakeholders to improve dissemination and implementation of results. We want to provide more specifically useful input for stakeholders such as systematic overviews of results for professional clinical guidelines, for the Dutch Health Care Insurance Board and the health care insurances and for patient organisations.
Country: The Netherlands
Description of population served: The Netherlands
Population served (mil): 16.8
Current HTA budget (mil USD): 13.2
Permanent staff: 10.6
Ongoing TA projects: 120
Director: Mr. Henk J. Smid
Contact person: Mrs. Mariëlle Snijders
The Netherlands Organisation for Health Research and Development
P.O. Box 93245
NL-2509 AE The Hague The Netherlands