Radiopharmaceutical products used for diagnosis or treatment can be reimbursed through the Belgian compulsory health insurance. Their reimbursement follows a specific procedure managed by the National Institute for Health and Disability Insurance (RIZIV/INAMI), with the Technical Council for Radioisotopes (TRRI/CTRI) playing a central advisory role.
Below we answer some frequently asked questions about the Belgian reimbursement pathway for radiopharmaceuticals.
How are radiopharmaceuticals reimbursed in Belgium?
The Belgian reimbursement procedure for radiopharmaceutical products is based on a system comparable to that used for reimbursable pharmaceutical specialties.
A radiopharmaceutical product is reimbursable only when it is included in the list of reimbursable radiopharmaceutical products and the applicable reimbursement conditions are met.
The reimbursement list is divided into two chapters:
- Chapter I: radiopharmaceutical products used for treatment
- Chapter II: radiopharmaceutical products used for diagnosis
The list of reimbursable radiopharmaceutical products is updated regularly by RIZIV/INAMI.
Who evaluates a radiopharmaceutical reimbursement application?
Applications are evaluated by the Technical Council for Radioisotopes (TRRI/CTRI).
The TRRI/CTRI is the advisory body responsible for radiopharmaceutical reimbursement within RIZIV/INAMI. Among other responsibilities, it formulates proposals concerning the inclusion of new radiopharmaceutical products, changes to existing reimbursement conditions and removal of products from the reimbursement list.
The final reimbursement decision is taken by the Minister of Social Affairs.
Is reimbursement different for diagnostic and therapeutic radiopharmaceuticals?
Yes. The Belgian reimbursement framework distinguishes between radiopharmaceuticals used for treatment (Chapter I) and those used for diagnosis (Chapter II).
This distinction can affect the reimbursement category, reimbursement conditions and patient contribution. The appropriate reimbursement strategy should therefore consider not only the characteristics of the product itself, but also its intended use and position within the Belgian diagnostic or therapeutic pathway.
What criteria are considered for reimbursement?
The reimbursement assessment is based on five main criteria:
- the value of the radiopharmaceutical product;
- the proposed ex-factory price, reimbursement category and reimbursement basis;
- the importance of the product in medical practice;
- the expected budget impact for the compulsory health insurance, taking into account the available budget; and
- the relationship between the cost to the health insurance and the value of the product, including cost-effectiveness.
The value assessment may consider several dimensions, including effectiveness, safety, applicability and patient or healthcare professional comfort, as well as other relevant characteristics determining the place of the radiopharmaceutical within the diagnostic or therapeutic pathway compared with available alternatives.
What is the difference between pricing and reimbursement of a radiopharmaceutical in Belgium?
Pricing and reimbursement are related but distinct processes in Belgium.
The price concerns the maximum ex-factory price at which the radiopharmaceutical can be marketed. Pricing falls under the responsibility of the Federal Public Service (FPS) Economy.
Reimbursement determines whether, under which conditions and at what reimbursement basis the radiopharmaceutical is covered by the Belgian compulsory health insurance. Reimbursement applications are assessed within RIZIV/INAMI, with the Technical Council for Radioisotopes (TRRI/CTRI) acting as the relevant advisory body.
Companies should consider the pricing and reimbursement strategy together, even though they involve different authorities and procedures.
How can LIVV support radiopharmaceutical reimbursement in Belgium?
LIVV supports companies developing or commercialising radiopharmaceuticals in navigating the Belgian market access and reimbursement pathway.
Our support can include reimbursement pathway assessment, reimbursement landscape analysis, TRRI/CTRI strategy, evidence assessment, budget impact analysis, dossier preparation and medical writing, submission support and follow-up during the reimbursement procedure.
Early assessment of the Belgian reimbursement landscape can help identify the appropriate positioning, evidence requirements and potential reimbursement challenges before submission.
Contact us for more information
Resources and author
Official Belgian sources
- RIZIV/INAMI information for companies responsible for radiopharmaceutical products
- current list of reimbursable radiopharmaceutical products
About the author
Barbara D’haene is a Belgian market access consultant and co-founder of LIVV, specializing in pricing and reimbursement of (radio)pharmaceuticals and medical devices in Belgium. Her work includes reimbursement strategy, dossier development, health technology assessment and interactions with stakeholders.
Last reviewed: September 2026