OBJECTIVES: In 2006, the National Healthcare Institute (ZIN) initiated conditional financing (CF) of expensive hospital drugs as an example of conditional reimbursement schemes (CRS). CF is a 4-year procedure encompassing initial HTA assessment (T=0) followed by additional data collection via outcomes research (separately assessing appropriate use & cost effectiveness in routine practice) and re-assessment (T=4). This study aims to retrospectively evaluate the CF framework, focusing on Health Technology Assessment (HTA) procedures.

METHODS: All dossiers for drugs that underwent the full CF procedure were reviewed. Using a standardised data extraction form, 2 researchers independently extracted information on procedural, methodological and decision-making aspects from HTA reports of drugs selected for CF.

RESULTS: CONCLUSIONS: Theoretically, CF provides a valuable option for enabling quick but conditional access to medicines in the Netherlands. However, procedural, methodological and decision-making considerations related to scheme design and implementation may affect its value in decision-making practice. Shortcomings and learnings identified should inform recommendations for the development of future managed entry agreements worldwide.