Belgium Ends Reimbursement for Two ADHD Drugs in November
People in Belgium who use Rilatine to treat ADHD may notice a change in how much they pay at the pharmacy. Since November 1, 2026, health insurance no longer reimburses two specific types of Rilatine Modified Release (MR).
The change affects the 20 mg and 30 mg versions, but it does not mean that all Rilatine medication has lost its reimbursement. Other forms of the medicine remain covered, and patients can still receive reimbursement for certain alternatives.
The change was confirmed by the National Institute for Health and Disability Insurance (RIZIV-INAMI) on October 30.
Which Rilatine medications are no longer covered?
From November 1, health insurance no longer reimburses these packages:
- Rilatine Modified Release 20 mg (30 capsules).
- Rilatine Modified Release 30 mg (30 capsules).
These are extended-release versions of Rilatine. They contain methylphenidate, a substance commonly used to treat attention deficit hyperactivity disorder (ADHD).
Importantly, the change does not affect Rilatine 10 mg. Its reimbursement rules remain unchanged.
The affected medicines will also remain available in Belgian pharmacies. Patients can still buy them, but they will no longer receive health insurance reimbursement for the two affected packages.
Why has Belgium stopped reimbursing these versions?
The decision was made at the request of InfectoPharm, the company responsible for marketing the affected medicines.
The change follows the arrival of cheaper generic medicines containing the same active ingredient, methylphenidate.
When generic alternatives enter the market, the original medicine may face pressure to reduce its price or reimbursement base to remain covered by health insurance.
According to Health Minister Frank Vandenbroucke’s office, the company chose to remove the two Rilatine MR packages from the reimbursement system rather than keep them under the new conditions.
The minister’s office expressed regret over the decision, pointing out that competition from generic medicines is expected to help reduce costs for patients and the health insurance system.
Which ADHD medication alternatives are still reimbursed?
Patients who need extended-release methylphenidate can still receive reimbursement for several alternatives, subject to the applicable conditions.
The main options include:
- 10 mg
- 20 mg
- 30 mg
“Methylphenidate RX EG”
- 10 mg
- 20 mg
- 30 mg
Both options contain methylphenidate, the same active ingredient found in Rilatine. They remain included in Belgium’s reimbursement system under the applicable rules.
What should current Rilatine MR patients do?
RIZIV-INAMI has introduced a transition measure to help patients continue their treatment without having to start a new reimbursement application.
If a patient already has an approval from their health insurance fund (mutualité or ziekenfonds) for Rilatine MR, that authorization will automatically be converted to cover the eligible alternatives, Equasym XR and Methylphenidate RX EG.
However, there is one important step: patients still need to contact their doctor.
From November 1, the doctor must prescribe one of the reimbursed alternatives. A new administrative reimbursement application is not required if the patient already has a valid authorization for Rilatine MR.
This means patients should not assume that their old prescription is enough to collect the alternative medicine from the pharmacy.
Could patients pay less for their medication?
Switching to a reimbursed alternative may also reduce the amount patients pay themselves.
For example, the reported personal contribution for a 20 mg package of Rilatine MR was 6.12 euro. For Equasym XR 20 mg, it was 3.38 euro.
That represents a difference of 2.74 euro per package.
However, these figures apply to the specific 20 mg packages mentioned. The amount patients pay may differ depending on the medicine, dosage and reimbursement conditions.
Will patients need to change how they take their medication?
Although the alternatives contain the same active ingredient, they may not release it into the body in exactly the same way.
This can affect how long the medicine works and when it has its effect during the day. Some patients may therefore need adjustments to their medication schedule when switching to another brand.
Patients should discuss the change with their doctor, who can decide which alternative and dosage are appropriate.
Important: The reimbursement change does not mean patients should stop taking Rilatine or change their dosage themselves. Anyone currently using Rilatine MR should contact their doctor to arrange a suitable prescription and maintain continuity of treatment.
