Table 2

Negative reimbursement decisions in reports with suboptimal evidence of effectiveness; arguments that advocated against the acceptance of the available evidence

InterventionArguments that advocated against the acceptance of the available evidence†
VI. Transcatheter aortic valve implantation (TAVI) for patients with aortic valve stenosis*13
  • Substantial intervention-related mortality, probably (partly) related to a priori risk profile of study population

  • No comparative studies available and the quality of the available evidence is poor (ie, limited duration and limited size)

  • Randomised controlled trial (RCT) is on-going

VII. Psychoanalysis15
  • Insufficient studies (qualitatively adequate) on the effectiveness available

  • Existence of several comparative effectiveness studies on long-term psychoanalytic psychotherapy makes it likely that such studies are also possible for psychoanalysis

VIII. Breast augmentation with autologous lipofilling16
  • Insufficient studies on the effectiveness available (majority are case reports and non-comparative studies)

  • No consensus on breast augmentation with autologous lipofilling (unclear whether possible microcalcifications influence the assessment of mammograms)

  • *In October 2011, this advice was changed. In the opinion of the Dutch National Health Care Institute (ZIN), TAVI is care that complies with established medical science and medical practice for insured persons with severe stenosis of the aortic valve and for whom the surgical risks are unacceptably high. TAVI belongs in the insured basic package for these insured persons.

  • †Essential arguments are shown in bold.