Over the borders
Situation in Germany
In Germany there is a regulation that makes it possible for a doctor to give PSMA therapy to patients who no longer have other treatment options, without participating in a study. This is usually reimbursed for German patients who have completed treatment by the German health insurance companies. This expressly only applies to patients who have finished treatment, although in practice we sometimes see that German hospitals are not so precise with foreign patients, and that Dutch patients have even been treated in an earlier phase of illness. However, given the limited experience in an early phase of disease, it is advisable to carry out early phase treatment only in a study context. This may result in a label expansion for PSMA therapy at an earlier stage. . Treatment in Germany is often paid for by Dutch patients themselves. However, you can talk to your health insurance company for the possibility of reimbursement.
Paying for PSMA therapy yourself is considered unethical in the Netherlands because it leads to differences in treatment options between patients, dependent on individual financial capacity. It is therefore impossible to pay for PSMA therapy as a Dutch patient in the Netherlands. Obviously, it is unavoidable that those who can afford it may choose to go abroad for PSMA therapy.
In Germany, the treatment for German patients is usually reimbursed by their health insurer. The costs for Lutetium-PSMA therapy in Germany vary greatly per clinic, with a current average of about 8000 euros per injection. Usually, 2 to 6 injections are given.
Therapy Abroad: route
When a patient wants to go to Germany for PSMA therapy, this always goes through the attending physician in the Netherlands (urologist or oncologist). The attending physician and the patient jointly decide which foreign center best suits the needs of the patient. Information needed for a referral: an overview of treatments for prostate cancer, an overview of any other diseases, a list of medicines used, recent blood results (PSA, Hb, LDH, white blood cells, platelets, kidney function), a recent (<<8 weeks old) PSMA PET/CT to demonstrate that the metastases absorb PSMA well. The supervisor of the therapy abroad, the attending physician in the Netherlands, the patient and the treatment center abroad communicate to make agreements together.