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Country profiles of health system responses to the crisis | Belgium
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• Status of “chronic illness” introduced (2013), automatically assigned by
the sickness fund to patients with at least €300 of health care expenses per
trimester (not only OOP) for eight consecutive trimesters or who were entitled
to the lump sum payment for the chronically ill. Patients suffering from a rare
or orphan disease are also entitled to the new status. Patients with the chronic
illness status are automatically eligible for the lower co-payment ceiling (as of
1 January 2013) and will be eligible for third-party payer arrangements (as
of 1 January 2015).
Changes to health service planning, purchasing and delivery
Prices of medical goods
• Reduction in covered drug prices by 15–17% in 2010 and by 17–19% in
2011. This measure only applies to medicines that had been reimbursed
for a long time.
• Maximum reimbursement price set for drugs no longer under patent
(2010).
• Price of originals reduced by 31%-41% (2011); all drug prices cut by
1.95% (2012).
• Legislation expanded to allow risk-sharing volume agreements for
products without added therapeutic effect (2010).
• Drug companies obliged to submit the ex-factory prices of drugs under
patent in six EU countries (Austria, Finland, France, Germany, Ireland,
the Netherlands) to allow price comparisons (2012).
• Pharmacists must offer drugs in the cheapest category for INN
prescriptions (2011) and acute antibiotic or antifungal treatments (2012).
Salaries and motivation of health sector workers
• Impulseo III programme aimed at strengthening primary care through
granting financial incentives to GPs to establish their practices in deprived
areas (2012).
• Physicians unions and the government agreed to make a saving of
€105 million by limiting and reallocating the funding available for
indexation of physician fees. The indexation of fees for clinical biologists
was set at 1%; medical imaging, surgery and gynaecology services at
1.5%; GP and specialist consultations at 2%; and consultations for some
specialists (neurologists rheumatologists, geriatricians, dermatologists) at
5%. Dialysis fees were not modified (2013).
• Financial incentive designed to motivate GPs to use electronic health records
revised to optimize the effective implementation in primary health care (2013).