Belgian Reimbursement Update – July 2026: targeted access gains, tighter legacy routes

The July 2026 update shows three clear signals.

First, access broadening continues in selected high-need and specialist-driven areas, particularly in inflammatory disease, oncology and immunology.

Second, oncology and immunology contain some of the most substantive changes this month, with new or clearer reimbursement routes in CLL, multiple myeloma, lupus nephritis and giant cell arteritis.

Third, not every update expands access. Some legacy pathways are being tightened, with continuation-only logic or narrower criteria for new starts.

Dermatology: Nemluvio enters reimbursement

Nemluvio (nemolizumab) receives first reimbursement in Belgium and is commercially available as pre-filled subcutaneous injection pens.

This introduces a new IL-31 pathway option in the biologic landscape, with reimbursement covering prurigo nodularis and severe atopic dermatitis.

From a market access perspective, this is a meaningful dermatology development. It adds a new targeted mechanism in areas where disease burden can be high, treatment pathways are specialist-led, and positioning versus existing biologic options will matter.

Belgium is continuing to absorb more targeted immunology and dermatology options, but in controlled, indication-specific ways.

Respiratory & ENT: Tezspire expands into CRSwNP

Tezspire (tezepelumab) pens and pre-filled syringes see a new reimbursed indication in severe chronic rhinosinusitis with nasal polyps.

This broadens biologic access across type 2 airway disease and moves tezepelumab beyond its existing asthma positioning.

Oncology: new later-line and combination routes in CLL

In chronic lymphocytic leukaemia, July brings relevant reimbursement movement for both Jaypirca and Venclyxto.

Jaypirca (pirtobrutinib) becomes reimbursed after prior covalent BTK inhibitor treatment. That creates a later-line route for patients who have already moved through earlier BTKi therapy.

Venclyxto (venetoclax) gains a clearer reimbursement route in combination with ibrutinib.

Multiple myeloma: lenalidomide broadens in first line

Lenalidomide broadens in the transplant-eligible D-VRd setting.

The July update formalises reimbursement in this first-line context and clarifies continuation logic after initial treatment. This reinforces lenalidomide as a backbone therapy in multiple myeloma.

Immunology & rheumatology: two new reimbursed indications

Two important new reimbursed indications appear in immunology and rheumatology.

Gazyvaro (obinutuzumab) enters reimbursement for lupus nephritis.

Rinvoq (upadacitinib) enters reimbursement for giant cell arteritis.

Both changes come with response-based continuation controls. This illustrates how Belgium balances innovation access with ongoing control.

Access tightening: not every change broadens access

Some July changes move in the opposite direction.

Arikayce (amikacin liposomes for inhalation) becomes continuation-only for existing Mycobacterium avium complex pulmonary disease patients. New starts are no longer reimbursed.

Takhzyro pre-filled syringes (lanadelumab) moves out of temporary reimbursement in definitive listing, but see narrower criteria for new starts in hereditary angioedema, while existing patients retain access through transition routes.

Neurology: Vimpat reduces administrative burden

In neurology, Vimpat (lacosamide) oral therapy remains a later-line add-on therapy in partial epilepsy.

The substantive change is administrative, but it changes the patient and prescriber experience: the authorisation now has unlimited validity. That means less repeat paperwork for stable patients.

Farmanaut take-away

July 2026 is a targeted update.

The clearest access gains appear in oncology, immunology, dermatology and respiratory disease. At the same time, some legacy routes tighten, and some changes mainly reduce administrative burden.

The broader signal is this: Belgian reimbursement is becoming increasingly precise. More pathway-specific. More dependent on prior treatment. More controlled through continuation logic. And occasionally, mercifully, a little lighter on paperwork.

About Farmanaut

Farmanaut is a software-as-a-service platform that helps Belgian Market Access teams monitor reimbursement changes, track market access timelines and anticipate pricing and reimbursement strategy.

Want to see how Farmanaut can support your reimbursement monitoring? Contact us at info@digile.be for a demo.