title: Contested evidence: a Dutch reimbursement decision taken to court.
abstract: This paper examines a remarkable lawsuit in health care rationing. The Patients Association for Interstitial Cystitis sued the Dutch National Health Care Institute for alleged misconduct against Interstitial Cystitis patients, as the Institute decided that bladder instillations with chondroitin sulphate or hyaluronic acid are no longer covered by the basic health insurance. The patients' organisation challenged the Institute for basing its standpoint on scientific evidence; overruling clinical expertise and patients' experiences. While scientific advice is often solicited in public health issues, simultaneously, the authority of scientific advice is increasingly being questioned in the public domain. Also, the judiciary is frequently called upon to adjudicate in rationing decisions. Based on an ethnographic study of the National Health Care Institute, drawing on insights from the field of Science and Technology Studies, we analyse this lawsuit as a negotiation of what knowledge counts in reimbursement decisions.
authors.affiliation: 1Department of Health, Ethics and Society,Research School CAPHRI,Maastricht University,Maastricht,the Netherlands.
authors.forename: Floortje
authors.initials: F
authors.lastname: Moes
authors.affiliation: 1Department of Health, Ethics and Society,Research School CAPHRI,Maastricht University,Maastricht,the Netherlands.
authors.forename: Eddy
authors.initials: E
authors.lastname: Houwaart
authors.affiliation: 2Tranzo (Scientific Centre for Care and Welfare),Tilburg University,Tilburg,the Netherlands.
authors.forename: Diana
authors.initials: D
authors.lastname: Delnoij
authors.affiliation: 1Department of Health, Ethics and Society,Research School CAPHRI,Maastricht University,Maastricht,the Netherlands.
authors.forename: Klasien
authors.initials: K
authors.lastname: Horstman
mesh_terms: D000884:Anthropology, Cultural; D018856:Cystitis, Interstitial / Q000628:therapy*; D003657:Decision Making; D015276:Health Care Rationing / Q000331:legislation & jurisprudence*; D006801:Humans; D007348:Insurance, Health / Q000331:legislation & jurisprudence*; D009426:Netherlands; D012051:Reimbursement Mechanisms / Q000331:legislation & jurisprudence*