Dutch Healthcare Institute approves reimbursement of whole genome sequencing (WGS) for targeted cancer treatment 

The Dutch National Health Care Institute (Zorginstituut Nederland, ZiNL) has approved the reimbursement of whole genome sequencing (WGS) through the national basic health insurance package for patients who may benefit from NTRK inhibitor therapy. This policy change formally recognizes WGS as meeting established criteria for both scientific and clinical validity — marking a pivotal advancement toward the integration of WGS into routine oncological diagnostics in the Netherlands. 

“This decision not only enables access to WGS-based diagnostics for a large cohort of patients eligible for targeted therapies but also represents a critical milestone in embedding WGS into standard cancer care,” said Prof. Edwin Cuppen of the Hartwig Medical Foundation. “It affirms WGS as a robust, comprehensive, and future-ready diagnostic modality’.’  

Direct Access for Eligible Patients 

With WGS now covered under basic insurance, clinicians can directly request testing for patients in good clinical condition who are candidates for NTRK inhibitors — particularly those with rare, refractory, or treatment-resistant solid tumors for whom standard therapies are no longer effective. 

Most comprehensive diagnostic test 

 ZiNL highlights the necessity of high-fidelity molecular diagnostics, especially when prescribing high-cost targeted therapies that may only benefit a subset of patients and could carry adverse effects. The current reimbursement policy pertains to the use of entrectinib and larotrectinib, both approved NTRK inhibitors. However, the Institute also underscores the broader need for advanced diagnostics to support the expanding landscape of precision oncology. According to ZiNL, WGS is demonstrably as effective as existing molecular diagnostics such as panel-based next generation sequencing (NGS). ‘Technically, WGS is the most comprehensive form of NGS. It maps the entire tumor genome.’ 

All-in-one diagnostic platform  

In addition to identifying NTRK fusions, WGS provides several important advantages: 

• Comprehensive profiling: A single assay captures the full genomic architecture of the tumor, including rare or unexpected mutations. 

• Expanded therapeutic opportunities: Detection of additional actionable alterations enables patient referral to clinical trials or off-label targeted therapies. 

• Broad tumor applicability: WGS is suitable for nearly all solid tumor types, promoting consistency and scalability across institutions 

Evidence-based decisions 

The broad applicability of WGS contributes to a learning healthcare system: by systematically collecting and analyzing data, we can better understand what treatment works — and for whom. This enables more personalized, evidence-based care decisions and helps ensure that new high-cost treatments reach the right patients without unnecessarily straining healthcare budgets. 

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