The Belgian reimbursement update effective 1 November 2026 introduces several meaningful changes across oncology, neurology, dermatology, rare diseases and hepatology.
The strongest market access signals include new reimbursement pathways for targeted oncology treatments, first reimbursement of inebilizumab in two neurological conditions, and new treatment options in severe alopecia areata and chronic hepatitis D. Other changes broaden eligibility within existing reimbursement pathways or improve practical access through revised administration and authorisation requirements.
Below is a curated overview of the developments most relevant from a market access perspective.
🎗️ Oncology and hematology: new reimbursed treatment pathways
Tagrisso (osimertinib) gains a first-line combination reimbursement pathway in EGFR-mutated NSCLC
Tagrisso gains reimbursement in combination with pemetrexed and platinum-based chemotherapy for eligible adults with locally advanced or metastatic EGFR-mutated non-small-cell lung cancer.
The new pathway extends the reimbursed role of osimertinib beyond its existing treatment settings and establishes a corresponding reimbursement route for pemetrexed.
This adds another reimbursed first-line treatment approach for a molecularly defined NSCLC population.
Tecartus (brexucabtagene autoleucel) extends CAR-T reimbursement to adult B-cell precursor ALL
Tecartus gains reimbursement for selected adults with relapsed or refractory B-cell precursor acute lymphoblastic leukaemia.
Already reimbursed in another haematological indication, Tecartus now extends its role within Belgium's CAR-T treatment landscape to an additional population with limited treatment options.
🧠 Neurology: expanding access and reshaping reimbursement
Uplizna (inebilizumab) enters reimbursement in two neurological conditions
Uplizna receives its first Belgian reimbursement for adults with aquaporin-4 antibody-positive neuromyelitis optica spectrum disorder (NMOSD) and selected patients with generalised myasthenia gravis (gMG).
The two indications have distinct reimbursement requirements, with separate initiation and maintenance pathways for gMG.
Commercialisation starts on 1 November, aligning product availability with the introduction of reimbursement.
Rilatine Modified Release exits reimbursement
Rilatine Modified Release loses reimbursement for its affected ADHD and narcolepsy presentations from 1 November 2026.
Other methylphenidate treatments remain reimbursed, in a market also affected by the opening of a reference reimbursement cluster for methylphenidate.
The withdrawal highlights how reimbursement changes can reshape access within an established therapeutic class, even when alternative treatments remain available.
🩹 Dermatology and rheumatology: expanding targeted treatment access
Litfulo (ritlecitinib) expands reimbursed alopecia areata treatment to adolescents
Litfulo receives its first Belgian reimbursement for eligible adolescents and adults with severe or very severe alopecia areata.
While Olumiant (baricitinib) is already reimbursed for adults, Litfulo introduces a reimbursed targeted treatment option for adolescents aged 12–17 years and an additional therapeutic choice for adults.
The change therefore combines a meaningful expansion of patient access with a broader reimbursed treatment landscape for severe alopecia areata.
Simponi (golimumab) extends reimbursement to younger patients with juvenile idiopathic arthritis
Simponi gains a dedicated reimbursement pathway for children with active polyarticular juvenile idiopathic arthritis following insufficient response to methotrexate.
The extension introduces weight-adapted treatment options and response-based continuation requirements, expanding golimumab's reimbursed role in paediatric rheumatology.
🧪 Hepatology: first reimbursement for chronic hepatitis D
Hepcludex (bulevirtide) becomes the first treatment with a dedicated Belgian reimbursement pathway for chronic hepatitis D
Hepcludex receives its first Belgian reimbursement for selected adults with chronic hepatitis D and advanced liver fibrosis.
Previously accessible to selected patients through a Medical Need Programme, Hepcludex enters regular reimbursement and starts commercialisation on 1 November 2026. This marks an important transition from early access to established reimbursement.
🧩 Nephrology and rare diseases: broader eligibility within existing treatment pathways
Aspaveli (pegcetacoplan) adds an alternative reimbursement route in PNH
Aspaveli's existing reimbursement conditions for paroxysmal nocturnal haemoglobinuria are expanded to include an additional pathway for patients with high disease activity and defined clinical manifestations.
The changes broaden the clinical situations covered by established reimbursement, while earlier transitional access provisions are removed.
Kinpeygo (budesonide) lowers the proteinuria threshold in primary IgA nephropathy
Kinpeygo's reimbursement criteria are revised to allow access for eligible patients with lower levels of proteinuria than previously required.
This expands the laboratory-defined population potentially eligible for reimbursed treatment and represents a meaningful change in the management of primary IgA nephropathy.
🩺 Gastroenterology
Tremfya (guselkumab) adds subcutaneous induction in ulcerative colitis
Tremfya's reimbursement framework for severe ulcerative colitis now accommodates a subcutaneous induction regimen alongside the existing intravenous approach.
The corresponding maintenance pathways are also updated, introducing greater flexibility in the reimbursed treatment sequence.
Market access read-out
November 2026 is characterised by new targeted treatment access in oncology and neurology, alongside expanded access to alopecia areata treatment for adolescents and the first dedicated reimbursement pathway for chronic hepatitis D.
Broader eligibility for Aspaveli and Kinpeygo shows that meaningful access changes also occur within established reimbursement pathways. Meanwhile, the introduction of an additional subcutaneous induction pathway for Tremfya highlights how reimbursement changes can provide greater flexibility within established treatments.
Taken together, the November update brings new therapeutic options and broader eligibility, while the withdrawal of Rilatine Modified Release illustrates that reimbursement changes can also restrict access within established treatment classes.