Why some Dutch hospitals are paying €2,800 more for the same cancer drugs

Some hospitals in the Netherlands are paying up to €2,800 more than others for the same cancer medicines, according to research examining how oncology drugs are priced across European healthcare systems. The findings have raised concerns about the lack of transparency in pharmaceutical negotiations and the impact that confidential pricing agreements can have on public healthcare budgets.

The study was conducted by researchers at the Netherlands Cancer Institute with support from the Dutch Cancer Society. By analysing drug price data from hospitals across several European countries, the research aimed to determine how widely the cost of identical cancer treatments can vary between institutions.

Researchers compare prices across European hospitals

The analysis focused on the prices paid for 15 cancer medicines across 23 hospitals in nine European countries, including six hospitals located in the Netherlands. The aim was to understand whether hospitals were paying similar prices for identical treatments or whether significant differences existed.

The results showed that Dutch hospitals sometimes paid thousands of euros more per patient for the same medicines than other hospitals within the country. In the most extreme cases identified in the research, the price difference reached €2,800 per treatment.

Researchers emphasised that these disparities are not caused by variations in the medicines themselves. Cancer drugs supplied to hospitals are standardised pharmaceutical products, meaning that identical treatments should theoretically be purchased at similar prices. Instead, the variations appear to stem from the individual agreements negotiated between hospitals and pharmaceutical manufacturers.

Price differences identified in widely used treatments

Among the medicines analysed in the study, significant price variations were observed for several widely used cancer treatments.

One of the clearest examples involved Abiraterone, a hormone therapy commonly prescribed to treat metastatic prostate cancer. Hospitals included in the research paid notably different amounts for the same drug depending on the agreements they had negotiated.

Another medicine with considerable price differences was Lenalidomide, which is used in the treatment of multiple myeloma, a type of bone-marrow cancer. As with other medicines examined in the study, hospitals purchasing the drug were frequently unaware of the prices secured by other institutions.

The researchers noted that these examples illustrate a broader pattern within the pharmaceutical market, where hospitals negotiate contracts independently and often lack information about pricing elsewhere.

Confidential contracts limit price transparency

A central factor identified by researchers is the use of confidentiality clauses in pharmaceutical contracts. Hospitals typically agree not to disclose the price they pay for medicines when negotiating with drug manufacturers.

According to the authors of the study, these confidentiality agreements mean that hospitals have limited ability to compare prices with other institutions. Without access to this information, they may believe they have negotiated favourable deals even if the prices they pay are significantly higher than those paid elsewhere. Professor Wim van Harten of the Netherlands Cancer Institute said the research showed that hospitals can sometimes pay up to 22 per cent more than the average price for certain medicines due to this lack of transparency.

Because cancer medicines are among the most expensive treatments used in modern healthcare, even relatively small percentage differences can translate into substantial additional costs for hospitals and healthcare systems.

Wider disparities found across Europe

The study also found that pricing differences were not limited to hospitals within the Netherlands. When researchers compared hospitals across multiple European countries, the variations were sometimes even larger.

In certain cases, hospitals in different countries were found to pay more than double the price for the same cancer medicines. These findings highlight how national procurement systems, negotiation strategies and regulatory frameworks can influence the cost of pharmaceuticals.

Healthcare systems in Europe typically negotiate prices either at the national level or through individual hospital agreements. As a result, purchasing power and negotiating leverage can vary widely between countries and even between institutions within the same country.

Calls for more transparency in pharmaceutical pricing

Researchers and cancer organisations say the findings underline the need for greater transparency in how drug prices are negotiated.

They argue that allowing hospitals controlled access to information about the prices paid by other institutions could help strengthen their negotiating position when purchasing expensive medicines. Improved transparency could also reduce unnecessary differences in treatment costs across healthcare systems. Cancer charities emphasise that the goal of such reforms would not be to restrict access to innovative treatments but to ensure that hospitals pay fair and consistent prices for essential medicines.

The researchers involved in the study say greater price transparency could ultimately help make healthcare spending more efficient while maintaining patient access to life-saving cancer therapies.