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# Off-label oncology drug use spans over a third of reimbursable Dutch drug–cancer pairings
- URL: https://www.coios.me/off-label-oncology-drug-use-spans-over-a-third-of/
- Published: 2026-10-31T11:08:35.000Z
- Updated: 2026-10-31T11:58:35.000Z
- Description: In 2023 a quarter of Dutch high-cost cancer drug prescriptions were off-label, but they made up 2.3% of spending.
- Author: Daniel Ryan
- Tags: Health today, Cancer, Innovation in treatment, Netherlands, #peer-reviewed, #new, #item, #source-2026-10, #score-60

This study mapped off-label oncology drug use in The Netherlands and the Dutch framework for reimbursing it. Indication-drug pairs were classed from European Medicines Agency authorisations and European Society for Medical Oncology guidelines. As of January 2025, 331 of 930 (35.6%) reimbursable pairs were off-label, 90.3% involving high-cost drugs and 67.1% chemotherapy. In 2023, off-label use made up 24.4% of high-cost prescriptions but 2.3% (€30.3 million of €1.3 billion) of spending. Targeted therapies took 67.7% of off-label costs, and the framework reimbursed treatments meeting clinical-benefit thresholds. Evidence was reviewed only for selected treatments, and its strength varied for rarer indications.

*Why it is interesting: It puts national figures on how far cancer treatment runs beyond its licensed indications. Frequently used off-label treatments had strong evidence, while evidence for rarer indications varied.*

Source

[ESMO open, 30 October 2026](https://doi.org/10.1016/j.esmoop.2026.108609?ref=coios.me)

DOI

10.1016/j.esmoop.2026.108609

Type

Peer-reviewed article

Design

Cross-sectional observational mapping of 930 reimbursable oncology indication-drug pairs against national registry prescribing and expenditure data, 2023-25

Verdict

New finding

Driver

[Cancer](https://www.coios.me/d-cancer/)

Driver

[Innovation in treatment](https://www.coios.me/d-treatment-innovation/)