Citizens speak their minds: prescription drugs are important, but not at any price

What do citizens think about the prices of expensive prescription drugs? And what considerations do they find important when determining whether prices are socially acceptable? That is what Radboudumc, a university medical center in the eastern part of the Netherlands, studied using a forum and a national survey, commissioned by the National Health Care Institute of the Netherlands (Zorginstituut Nederland), the Dutch Healthcare Authority (NZa), and the Netherlands Authority for Consumers and Markets (ACM). Radboudumc’s conclusion: prescription drugs are important, but not at any price. Never before in the Netherlands have citizens been asked to participate substantively in the debate about prices of expensive prescription drugs. In the fall of 2025, the three organizations will take this input into consideration when drafting their recommendations for the Ministry of Health, Welfare and Sport (VWS) about socially acceptable prices of prescription drugs and the expenditures thereon.

“Expensive prescription drugs? Not at any price”

During a citizens’ forum, organized by Radboudumc, 24 citizens discussed at great length the prices of expensive prescription drugs. In addition, 880 Dutch citizens took part in a national survey about this subject. The most important conclusions: citizens are willing to accept higher prices if prescription drugs offer demonstrably significant health gains, improve the quality of life, or make sure that citizens can take part in society again. These are elements that the National Health Care Institute of the Netherlands already takes into consideration when assessing expensive prescription drugs. On the other hand, citizens are critical if there is uncertainty about efficacy or safety, if the prescription drug is marginally innovative, or if the price is significantly higher than in other countries. The elements of ‘uncertainty’ and ‘marginally innovative’ are already important in the current framework, but do not lead to concrete recommendations about a socially acceptable price.

These results reveal that there is broad support in society for taking a critical look at the prices of expensive prescription drugs. Citizens believe it is also important to create transparency about how these prices are determined.

Citizens’ perspectives are unique in the debate about expensive prescription drugs

The citizens’ forum, “Expensive prescription drugs,” and the supplemental survey are initiatives of the MAUG program (which, in Dutch, stands for Maatschappelijk Aanvaardbare Uitgaven Geneesmiddelen, which means ‘socially acceptable expenditures for prescription drugs’). Both of these were organized by Radboudumc in collaboration with research firm Motivaction. Over the course of two weekends in the fall of 2024, 24 citizens discussed in the forum various cases involving rare diseases, cancer, and chronic conditions. In these discussions, they received input from experts coming from science, ethics, and the prescription-drug sector. Never before in the Netherlands have citizens been involved in this way to participate substantively in the debate about the prices of expensive prescription drugs. The perspectives of citizens offer a unique insight into what society thinks of this question.

Citizens’ insights taken into account in recommendation to Ministry of Health, Welfare, and Sport

The results of this citizens’ forum offer ACM, the National Health Care Institute and the NZa valuable insights. It shows that there is support in society for taking a critical look at the asking prices of prescription drugs. As part of the MAUG program (external website) , the three organizations are working on recommendations regarding socially acceptable prices of prescription drugs and the expenditures thereon, as well as the promotion of healthy competition. Part of these recommendations is a framework for socially acceptable prices of prescription drugs. In this way, as many health gains as possible can be created for society with the available health-care budget. At the same time, the framework needs to ensure that individuals continue to be able to pay for health care, and that there is an incentive for manufacturers to develop affordable prescription drugs that society needs.

The MAUG organizations will take into consideration the results of Radboudumc’s citizens’ consultation in their recommendations for the Ministry of Health, Welfare, and Sport (VWS). These recommendations will be presented in the fall of 2025.

• Download the final report by Radboudumc here (external website) (in Dutch)
• Download the citizens’ position from the citizens’ forum on expensive prescription drugs here (external website) (in Dutch)
• Download the accompanying letter here (external website) (in Dutch)

ACM’s oversight over the prescription-drug sector

As an independent regulator, ACM ensures that markets work well for people and businesses, now and in the future. ACM ensures that market participants comply with the competition rules in the prescription-drug sector as well. Fair competition in the prescription-drug sector contributes to the availability and affordability of prescription drugs for patients, and gives manufacturers an incentive to keep innovating.

See also

• Competition in the pharmaceutical industry | ACM (in Dutch)