The Belgian reimbursement changes effective 1 August 2026 introduce several new treatment options, alongside targeted closures and practical improvements in prescribing and renewal.
Below is a curated overview of the changes most relevant to patient access.
🫁 Respiratory and sleep medicine
Ozawade opens a new reimbursed use for pitolisant
Ozawade (pitolisant) is newly reimbursed for adults with residual excessive daytime sleepiness associated with obstructive sleep apnoea despite effective and continued CPAP therapy.
This extends the reimbursed use of pitolisant beyond narcolepsy into a distinct sleep-disorder population. Continued access depends on treatment response and ongoing CPAP use. Ozawade is not yet commercially available on 1 August 2026.
🧬 Haematology and rare disease
Hympavzi adds a new prophylactic option in severe haemophilia
Hympavzi (marstacimab) is newly reimbursed for routine bleeding prophylaxis in eligible patients with severe haemophilia A or haemophilia B without factor inhibitors.
It introduces a new subcutaneous, non-factor prophylactic treatment option. Treatment must be coordinated through recognised haemophilia centres.
🧪 Vaccines and prevention
Capvaxive expands reimbursed pneumococcal vaccination options
Capvaxive (pneumococcal conjugate vaccine) is newly reimbursed for prevention in older adults at increased risk of pneumococcal infection because of specified comorbidities.
It adds another reimbursed conjugate vaccine option alongside Prevenar. Unlike the existing Prevenar pathway, access to Capvaxive is not subject to the same upper age limit, extending practical access to eligible patients above that threshold, unless Prevenar's reimbursement criteria are harmonized.
🎗️ Oncology
Nintedanib returns to the reimbursed lung cancer pathway
Nintedanib Accordpharma (nintedanib) is reimbursed in combination with docetaxel for adults with locally advanced, metastatic or recurrent lung adenocarcinoma after first-line chemotherapy.
The clinical access conditions remain broadly aligned with the former Vargatef pathway. Patients already treated through the previous listing can continue, although the new packs are not yet commercially available on 1 August 2026.
Imfinzi closes one pathway to new patients
Imfinzi (durvalumab) is no longer reimbursed for new treatment starts in the perioperative setting for resectable non-small-cell lung cancer.
Patients who started treatment before 1 August 2026 may continue. Other reimbursed durvalumab indications are not affected by this targeted closure.
Teysuno moves into transitional continuation
Teysuno (tegafur, gimeracil and oteracil) is no longer open to new reimbursed treatment starts in metastatic colorectal cancer and advanced gastric cancer.
Patients already receiving treatment may continue temporarily under transitional arrangements, but the active reimbursed pathway is effectively closed to new patients.
❤️ Cardiovascular medicine
Forxiga renewals can involve general practitioners
Forxiga (dapagliflozin) retains its existing reimbursed role across heart failure with reduced, mildly reduced or preserved ejection fraction.
The eligible patient populations do not change, but reimbursement renewals may now also be completed by general practitioners. Initial treatment initiation remains specialist-led.
🧠 Neurology
Sabril gains broader specialist access
Sabril (vigabatrin) remains reimbursed for eligible patients with drug-resistant epilepsy or West syndrome.
Neuropsychiatrists may now also confirm eligibility for reimbursement, making access somewhat easier operationally without changing the treated population.
Buccolam gains broader prescribing access
Buccolam (midazolam) remains reimbursed for the emergency treatment of prolonged acute convulsive seizures within an individual treatment plan.
Neuropsychiatrists may now also prepare the treatment plan, prescribe the medicine and submit reimbursement applications.
🧬 Haematologic malignancies
Imbruvica gains broader specialist eligibility
Imbruvica (ibrutinib) retains its reimbursed fixed-duration combination use with venetoclax in previously untreated chronic lymphocytic leukaemia.
Medical oncologists may now apply for reimbursement alongside clinical haematologists, modestly broadening operational access without changing the eligible patient population.
Market access read-out
The August update combines three different types of patient access change.
New reimbursed options are introduced for residual sleepiness in obstructive sleep apnoea, severe haemophilia and pneumococcal prevention. In parallel, several established oncology pathways move into run-off or transitional continuation. Other changes mainly reduce administrative friction by allowing a broader group of physicians to manage reimbursement applications or renewals.
The update therefore expands access selectively while tightening or closing a smaller number of mature treatment pathways.