The Belgian reimbursement update effective 1 October 2026 brings several meaningful access developments across respiratory disease, bone and mineral metabolism, nephrology and neurology.
The strongest signals are the introduction of a new CFTR-modulator across multiple cystic fibrosis populations, the first routinely reimbursed disease-specific medicine for achondroplasia, and broader complement-targeted treatment in C3 glomerulopathy and primary IC-MPGN. In neurology, the main change is practical rather than therapeutic, with wider prescriber access for several botulinum toxin reimbursement pathways.
🫁 Respiratory
Alyftrek (deutivacaftor + tezacaftor + vanzacaftor) broadens the reimbursed CFTR-modulator landscape
Alyftrek enters reimbursement as a new triple-modulator option in cystic fibrosis.
For patients with an F508del mutation, it adds another reimbursed option within an already established CFTR-modulator landscape. In the non-F508del setting, the new test-and-continuation pathway broadens access beyond the existing mutation-specific ivacaftor pathway to a wider group of patients with non-class 1 CFTR mutations, subject to demonstrated treatment response.
The October update therefore expands both therapeutic choice and genotype-defined access to CFTR-modulator treatment.
🦴 Bone & mineral metabolism
Voxzogo (vosoritide) introduces a reimbursed disease-specific treatment pathway in achondroplasia
Voxzogo becomes reimbursed for patients with genetically confirmed achondroplasia and open growth plates.
From a market access perspective, this introduces Belgium’s first routinely reimbursed disease-specific medicine for achondroplasia.
🧩 Nephrology
Aspaveli (pegcetacoplan) expands complement-targeted treatment in C3G and primary IC-MPGN
Aspaveli gains a new reimbursement pathway in C3 glomerulopathy and primary immune complex-mediated membranoproliferative glomerulonephritis.
Adult C3G already has a reimbursed complement-targeted option with iptacopan (Fabhalta). Pegcetacoplan therefore broadens the existing treatment landscape rather than creating it from scratch: it adds another reimbursed option in adult C3G, extends targeted treatment access to adolescents, and introduces a specific reimbursed pathway for primary IC-MPGN.
The access impact is therefore driven by both additional therapeutic choice and broader population coverage.
🧠 Neurology
Botulinum toxin reimbursement becomes accessible through a broader prescriber base
Several existing reimbursement pathways for Dysport, Botox and Xeomeen are updated across blepharospasm, hemifacial spasm, cervical dystonia and focal dystonia.
The reimbursed patient populations and therapeutic options remain essentially unchanged. The meaningful access change is practical, so that specialists in physical medicine and rehabilitation can now also request reimbursement, alongside the previously eligible specialties.
Market access read-out
October 2026 combines several distinct types of access change.
Taken together, the month is characterised by targeted expansion of access in clearly defined patient populations, alongside a smaller but practical easing of reimbursement access in neurology.