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Country profiles of health system responses to the crisis | Belgium
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Priority setting or protocols to change access to treatments, coordination
of care and patterns of use
• Improved coordination of care trajectories for diabetes and end-stage renal
failure in group GP practices (2009 onwards).
• The following measures taken to reduce health care consumption (2012):
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reduction of the volume of pharmaceuticals requiring a-priori approval
by the supervising physician of sickness funds, through stricter control of
whether patients receiving approvals for pharmaceutical reimbursement
fulfil the reimbursement criteria;
reduction of the prescribed volume of proton-pump inhibitors and
antibiotics;
reduction of the cost of drugs used (volume) in retirement homes
through compulsory use of therapeutic compendium and compulsory
purchase of drugs through hospital pharmacies (this is cheaper than
purchasing them from ambulatory pharmacies); and
limitation of the number of indications for which oxygen therapy can
be reimbursed.
• Introduction of compulsory use of therapeutic guidelines when
prescribing drugs in nursing homes (2012).
Waiting times
• No response reported (no major problems with waiting times in Belgium).
Health promotion and prevention
• Subsidies given for several tobacco, alcohol and drug prevention projects (since
2007).
• Pilots related to breast, cervical and colorectal cancer screening in Flanders
(2011 and 2012).
• A smoking ban imposed in indoor public places, except for isolated “smoking
rooms” (nationally, 2011).
• Free vaccination against human papillomavirus in Flanders (2010) and
nationally (2011).
• A national Cancer Plan (2008) launched.
• The National Action Plan for Alcohol 2008–2012 launched.
• GP-led preventive health care maintenance module launched for patients
aged 45–75 (2011).