Using Proportional and Absolute Shortfall in Reimbursement Decision-Making in the Netherlands: Implications for Oncology Drugs for Older Patients
Vivian Reckers-Droog, Steef Redeker, Jan Busschbach, Sylvia Vijgen, Angèl Link, Lonneke Timmers · 2026
Read Using Proportional and Absolute Shortfall in Reimbursement Decision-Making in the Netherlands: Implications for Oncology Drugs for Older Patients by Vivian Reckers-Droog, Steef Redeker, Jan Busschbach, Sylvia Vijgen, Angèl Link, Lonneke Timmers (2026) in the Tower of Babel, a free online library of public-domain works preserved in clean, searchable text. No sign-up. The full text is served as a plain-text file at a predictable URL, where text is present: https://antarctic-labs.com/tower-of-babel/pmc-13375662.txt.
Description
Vivian Reckers-Droog and colleagues examine two severity measures used in Dutch drug reimbursement in a 2026 study. Proportional shortfall is the primary metric for setting cost-effectiveness thresholds, while absolute shortfall is also reported. Though related, the two can disagree, and debate continues over which should capture disease severity in health technology assessment.
The team analysed 56 of 57 reimbursement dossiers published by the National Health Care Institute between May 2018 and April 2026. Twenty-eight dossiers formed a distinct group. Their proportional shortfall averaged 0.88, high, while their absolute shortfall averaged only 14.28 quality-adjusted life years. Twenty-seven of those concerned cancer drugs for older patients. The pattern shows that metric choice can systematically favour or penalise older cancer patients.
Catalog record
| CREATOR | Vivian Reckers-Droog, Steef Redeker, Jan Busschbach, Sylvia Vijgen, Angèl Link, Lonneke Timmers |
|---|---|
| YEAR | 2026 |
| COLLECTION | PAPERS |
| FORMAT | TXT |
| FILE SIZE | 30 KB |
| VERSION | 1.0 |
| LICENSE | CC BY 4.0 |
| RIGHTS | CC BY |
| SOURCE | Europe PMC |