SiRM concludes that during the first three years after publication of the Dutch medicines policy, the low-hanging fruit has been picked. Its publication has resulted in a sense of urgency in the healthcare field and has increased the pressure towards the pharmaceutical industry. Prices of innovative medicines have been reduced to a certain extent and appropriate use of innovative medicines has become an important theme. Now, halfway through the predetermined policy period, the time has come for high-hanging fruit: sustainable solutions for socially unacceptable prices and realizing appropriate use of innovative medicines. Moreover, additional indicators are needed to monitor policy effects in preparation of the ex post evaluation in 2022.

An established heat network has the characteristics of a natural monopoly. This makes abuse of market power by a heat supplier conceivable and motivates tariff regulation for (small) consumers. The current regulation stipulates a tariff at or below the cost for heating with gas; the gas reference. This gas reference will become less relevant in the long-term because there is a policy to use less natural gas and to levy higher taxes on natural gas. Therefore the Ministry of Economic Affairs and Climate has asked SiRM to investigate alternatives.