OBJECTIVES: The Dutch government introduced a lock procedure in 2015 to regulate access of expensive hospital drugs to the market. The lock intents to prevent uptake of ineffective drugs and to negotiate the price of effective drugs to regulate the impact on the health care budget.

METHODS: Using technology assessment reports from the Dutch Health Care Institute, we developed a method to quantify the effects of the lock. We used QALYs to quantify the health effect and also created insight in the budget impact of the price negotiations. The effects are calculated for the time during and after the lock, for which we used different scenarios. We estimated a total effect retrospectively, based on all drugs that completed the lock procedure between 2015 and 2021.

RESULTS: A total of 29 drugs have been included. The results indicate that the total health effect of drugs placed in the lock between 2015 and 2021 is a population health gain of 5,551 to 10,772 QALYs, dependent on the comparative route, using a time horizon of 5 years. The budget effect is a saving between €906 million and €1,185 million.

CONCLUSIONS: The results show that the lock does not capitalize on the potential health benefits of new innovative drugs in the short term, but that it limits health loss due to displacement in the long term. The long-term effects outweigh the short-term exclusion of new drugs from the market. These effects depend not only on the potential health benefits of the new drug, but also on the lead time of the comparative route and the price being negotiated. Policymakers can use these results to quantify the impact of their reimbursement procedures and stress the importance of a lock procedure.