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Belgium

2012: National Dementia Strategies (diagnosis, treatment and research)

Issues relating to medical treatment

The availability of medicines in general

In Belgium, medical drugs are classified into different reimbursement categories.

Medicines in category A for serious illnesses are fully covered by the system and free of charge for the patient.

For medicines in category B (useful drugs), the patient is required to pay 25% up to a ceiling of EUR 11.30 to EUR 14.10 depending on the size of the box.

For medicines in category C (less useful drugs), the patient is required to pay 50% up to a ceiling of EUR 14.10. This percentage may go up to 60% or 80% for certain medicines in this group which fall under category CS (ease drugs) or Cx (for example: contraceptives). [1]

The availability of Alzheimer treatments

All four AD drugs are available in Belgium and are part of the reimbursement system.

Conditions surrounding the prescription and reimbursement of AD drugs

Belgium has a very strict treatment protocol for drugs to be reimbursed. Amongst other things, it limits the prescription of AD drugs to specialist doctors, both for treatment initiation and for treatment continuation. For the reimbursement of acetylcholinesterase inhibitors, treatment can be initiated for people with an MMSE score between 24 and 12. Treatment can be continued until an MMSE score of 10 has been reached. Equally, it is possible to prescribe acetylcholinesterase inhibitors to people with MMSE scores over 24, but such requests need to be further explained and documented as part of the diagnosis of Alzheimer’s disease. Memantine can be prescribed to people with a score of between 15 and 3.

The Belgian system explicitly limits reimbursement to one class of drugs only, so that patients would not be able to receive bi-therapy under the system unlike some other European countries. According to the Ligue Nationale Alzheimer Liga, a significant number of patients and carers have to pay for their Alzheimer medicines, because their general practitioners failed to refer them to a specialist.

The reimbursement system does not impose any restrictions for the reimbursement of people living alone or in nursing homes.

Prescription and

reimbursement

Donepezil

Rivastigmine

Galantamine

Memantine

Available

Yes

Yes

Yes

Yes

Reimbursed

Yes

Yes

Yes

Yes

Drug reimbursed if

initially prescribed by

Specialist doctors

Specialist doctors

Specialist doctors

Specialist doctors

Continuing treatment

reimbursed if

prescribed by

Specialist doctors

Specialist doctors

Specialist doctors

Specialist doctors

Required examinations

Diagnostic protocol

Diagnostic protocol

Diagnostic protocol

Diagnostic protocol

MMSE limits

>10

>10

>10

15-3

Issues related to research

Belgium is involved in the EU Joint Programme – Neurodegenerative Disease Research (JPND) and is an associate member of the Joint Action “Alzheimer Cooperative Valuation in Europe (ALCOVE)”.

[1] European Commission (2012): MISSOC – Mutual information system on social protection : Social protection in the Member States of the European Union, of the European Economic Area and in Switzerland : Comparative tables

 

 
 

Last Updated: Tuesday 14 May 2013

 

 
  • Acknowledgements

    The above information was published in the 2012 Dementia in Europe Yearbook as part of Alzheimer Europe's 2012 Work Plan which received funding from the European Union in the framework of the Health Programme. Alzheimer Europe gratefully acknowledges the support it has received from the Alzheimer Europe Foundation for the preparation and publication of its 2012 Yearbook.
  • European Union
 
 

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