Home hospitalisation offers patients the opportunity to continue treatment started in hospital at home, receiving the medicines and medical care in their familiar surroundings. This can contribute significantly to their comfort and well-being. By combining the benefits of hospital care with the convenience of staying at home, home hospitalisation is ideal for patients who need extended care, but do not necessarily need to be lying in a hospital bed. Furthermore, it can reduce pressure on hospitals and healthcare providers.
Legislation
The Royal Decree of 22 June 2023 describes the criteria for home hospitalisation and specifies the list of active substances that hospital pharmacists may deliver in this context. This Decree establishes the conditions for the delivery of medicinal products and medical devices needed for their administration. It emphasises the importance of medicinal products stability during transport and storage, the safe and proper execution of preparation, the guarantee of medical supervision and the safe disposal of waste.
In the context of this Royal Decree, home hospitalisation refers to situations where care is provided in the patient's living environment as part of a treatment initiated in a healthcare institution.
Medicinal products which may be delivered during home hospitalisation
Only medicinal products containing active substances included in the aforementioned Royal Decree may be dispensed by a hospital pharmacist in the case of home hospitalisation. Check the list of active substances involved.
In the Authentic Source of Medicines (SAM), this information is available at medicine level. This indicates which medicinal products may be dispensed in the context of home hospitalisation. This data is available as open data and can be integrated into other applications.
Medicinal products containing active substances not included in the list, but necessary for the treatment of the patient with a medicinal product that is on the list, may exceptionally also be delivered (e.g. Sodium chloride 0.9%, solution for infusion). In this case, the patient's current health status must be taken into account and the medicinal product must be included in the treatment protocol. Therefore, with each delivery of the medicinal products that do appear on the lists, as many additional medicinal products can be delivered as required for the number of treatment days planned.
Evolution of the list of medicinal products
Updating the list can only be done following publication of a Ministerial Decree.
Active substances are only eligible for addition to the list if the following conditions are met:
- it involves antimicrobial or antitumoral medicinal products;
- the care provided in the patient's living environment is part of a treatment initiated in a healthcare institution;
- any side effects caused by the use of the medicinal product can be safely managed within the situation of home hospitalisation;
- the stability of the medicinal product during transport and storage outside the hospital can be guaranteed;
- the medical supervision of the patient required when the medicinal product is administered or shortly afterwards can be guaranteed;
- the reconstitution steps or operations the medicinal product still needs to undergo can be safely and correctly performed within the framework of a home hospitalisation;
- the waste associated with the use of the medicinal product can be safely handled.
Application to add active substances to the list, can be submitted by a professional association, organisation, or group of individuals withpractical experience and knowledge of good clinical practices. The application must be supported by an association of hospital pharmacists.
Practical steps to submit an application
- Fill in the template and send the application by e-mail to had-th@fagg-afmps.be with the following mention in the subject of the e-mail: ‘Application for home hospitalisation’.
- Add a cover letter giving the necessary arguments justifying and clarifying the need to include the active substances on the list, within the scope of application of the Royal Decree of 22 June 2023.
Reimbursement of medicines in the context of home hospitalisation
The list attached to the Royal Decree of 22 June 2023 specifies which medicinal products may be delivered by hospital pharmacists in the context of home hospitalisation.
However, this does not guarantee that these medicinal products are automatically reimbursed. The reimbursement of medicinal products is the competence of the National Institute for Health and Disability Insurance (NIHDI). More information can be found here.