Dutch Hospitals Test Performance-Based Payment for Off-Label Cancer Treatments

A Dutch research institute believes oncology patients should be covered for treatments not intended for their type of cancer—if the off-label treatments work in trials—and it’s trying out performance-based payments.

The Netherlands Cancer Institute-Antoni van Leeuwenhoek Hospital is launching a pilot study in which drugmakers and health insurers will share the financial gamble. More than thirty Dutch hospitals will take part in the clinical study to evaluate the model’s effectiveness.

The pilot study, which is part of a larger Drug Rediscovery Protocol (DRUP) project, will use Bristol-Myers Squibb’s cancer drug Opdivo (nivolumab) for off-label treatment of various rare tumors. The drugmaker will guarantee the medication costs for a patient’s 16-week evaluation phase, and the health insurers will reimburse patients for whom the off-label medicine appears safe and effective after the four-month analysis period.