Implementation of a novel, coordinated innovation policy of a National Society of Cardiology

Background Cardiology is a dynamic field, constantly evolving through innovations that have the potential to revolutionize patient care. Historically the process of incorporating these innovations into the reimbursed healthcare system in the Netherlands lacked coordination and was driven by individual hospitals and companies with a slow bottom-up acceptance. In 2022, the Netherlands Society of Cardiology (NVVC) took decisive action to address this barrier by establishing a streamlined, coordinated approach to prioritize and guide promising cardiological innovations towards inclusion in reimbursed healthcare. Purpose To provide an overview of the NVVC's innovative, coordinated approach to guiding groundbreaking cardiology innovations towards reimbursed healthcare. Methods The NVVC's Science & Innovation Committee, established in 2019, is responsible for overseeing the implementation of a structured innovation procedure. This bottom-up process is driven by contributions from specialized subspecialities Working Groups which help shape the “Innovation Agenda”. For each innovation, expert panels provide recommendations regarding the most appropriate pathway towards reimbursement. In 2022, the NVVC formalized a streamlined approach to guide promising cardiological innovations towards reimbursement, navigating six distinct pathways. Innovations are assessed for inclusion in the basic insurance package, either through open or closed pathways, with stakeholders such as, health insurers, the governmental Dutch Health Care Institute (ZINL), and the Dutch Healthcare Authority (NZa) each fulfilling specific regulatory and advisory roles in this collaborative effort. Results The first Innovation Agenda (2022) prioritized nine innovations not yet covered by reimbursed healthcare (Fig 1). Updates in 2024 and 2026 led to the addition of four new innovations. From the 13 innovations enlisted, two were accepted by the Government as reimbursed care: 1) pulmonary artery pressure monitoring, and 2) percutaneous mitral annuloplasty. One innovation, (cerebral protection during TAVI) was excluded from reimbursed care. Of the remaining 10 innovations, three are under governmental review for "Promising Care patwhay", while four are still in scientific research phases. By appeal of the NVVC, ZINL is currently re-evaluating new evidence for renal denervation. The two innovations added in 2026 are now undergoing the process to define the appropriate route to become reimbursed care. Conclusion The NVVC's structured approach has enabled optimal prioritization of innovations with a high potential to become reimbursed healthcare, thereby reducing ad hoc requests with a low priority. This collaborative strategy has led to significant progress and may serve as blueprint for other countries. The next step will be to focus on the integration of e-health and AI into clinical practice.