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Belgium’s healthcare plans for 2026 – and where pharma fits in

Every year, Belgium’s federal ministers publish their policy notes for discussion in Parliament. They give a high-level snapshot of what each minister plans to focus on in the coming year. For the pharmaceutical industry, the healthcare policy note is usually the one to watch. Interestingly, the economic policy note also weighs in on pharma this year. In this blog post, we unpack the key policy signals for the pharmaceutical sector and group them around three main pillars: budget, accessibility, and pricing.

Pillar 1 – Budget

Budgetary measures have become a central part of Belgium’s healthcare policy. For 2026, the government expects the pharmaceutical sector to contribute €227.9 million. Some measures requiring immediate action were already implemented in legislation adopted at the end of 2025 and have been covered in a separate blog post.

Expected measures for 2026 include:

• Mandatory discounts on medicine prices – From 2026 onward, all companies marketing reimbursable medicines in Belgium must pay a discount to the compulsory sickness insurance. The discount is calculated proportionally based on each company’s adjusted turnover for reimbursable medicines relative to the total adjusted turnover of all companies. A safety net will protect older medicines and those for small markets. Details are outlined in the 2026 healthcare budget
  
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• Post Reimbursement Fund – Starting in 2026, the industry will contribute €10 million annually to a fund supporting clinical studies on dose optimization, treatment duration, and stopping rules. This aims to improve volume control, particularly for high-cost therapies such as oncology treatments.

Pillar 2 – Accessibility

In addition to tightened budgetary discipline, the healthcare policy note places access to medicines high on the agenda. In this context, accessibility is closely intertwined with availability: patients can only access treatments if those treatments are effectively present on the market and reliably supplied.

The Minister reiterated Belgium’s ambition to play a leading international role in tackling medicine shortages:

• At EU level, the government advocates for a robust Critical Medicines Act, designed to strengthen Member States’ capacity to prevent and manage shortages, including through reinforcement of the EU solidarity mechanism. Belgium also intends to maintain a leadership role within European regulatory fora, notably within the European Medicines Agency (EMA) and the Heads of Medicines Agencies (HMA) network.
• Domestically, a key milestone is the launch in 2026 of the Stock Monitoring Tool, whichwas first launched in a pilot phase in 2024. Following the pilot, a draft Royal Decree now formalises the Stock Monitoring Tool, expanding its scope to cover prescription-only and reimbursable medicinal products. The key change: stakeholders must now report stock data daily, including end-of-day stock levels and volumes sold. The Royal Decree is scheduled to enter into force on 1 July 2026 but is currently still subject to scrutiny by the European Commission.

Enforcement is also set to intensify. The policy note announces thematic inspections targeting insufficient delivery service levels. In parallel, sanctions for actors that fail to comply with their public service obligation (i.e. the obligation imposed on full-line wholesalers to have a permanent stock of medicines sufficient to meet the needs of a given geographical area and to deliver orders at very short notice) will be significantly strengthened.

Pillar 3 – Pricing

Pricing and reimbursement of medicines often get mentioned in one breath, but Belgian law draws a clear line between the two. It is the National Institute for Sickness and Disability Insurance (NIHDI) that looks after reimbursement, while pricing is handled by the Federal Public Service (FPS) Economy.

In his policy note, the Economy Minister voiced his intention to simplify the current medicine pricing rules. The focus is on making price-determination and price-increase procedures faster and more efficient. Procedures that are no longer relevant, or that unnecessarily slow down the medicines market, would be shortened or scrapped altogether. The idea is to create a more supportive climate for bringing medicines to market – with would benefit both pharma companies and patients.

Conclusion

Belgium’s pharma plans for 2026 revolve around three connected pillars: budget, accessibility and pricing. The pharmaceutical sector faces a substantial budgetary effort, new structural contributions such as the Post Reimbursement Fund, and enhanced monitoring and enforcement in the context of shortages. At the same time, faster and more efficient pricing procedures signal an intention to keep Belgium an attractive and predictable market for bringing medicines to patients.

Beyond these national measures, the broader EU regulatory landscape (in particular the EU Pharma Package) will continue to influence the Belgian market, even where it is not explicitly reflected in the policy notes.

Written by: Bart Junior Bollen