General information

You have dispensed Forxiga® (dapagliflozine) 10mg to a patient or you have obtained this medicine from the pharmacy. The health care insurer does not yet reimburse this medication for treatment of symptomatic chronic heart failure with reduced ejection fraction. The producer of this medicine has therefore asked TBR Nederland to reimburse the costs of the Personal Contribution to the patient.

Dose Forxiga® 10mg
Type Tablets
Active ingredient DAPAGLIFLOZINE



With immediate effect this scheme is applicable for all adults (18 years and older) who are depend on Forxiga® 10mg for the treatment of symptomatic chronic heart failure with reduced ejection fraction. The full cost of Forxiga® 10 mg is reimbursed through TBR Nederland.

A doctor's statement is not required.

Who can submit a claim

  1. Patients or their caregiver can claim the Personal Contribution for Forxiga® 10mg online or by mail
  2. Pharmacists can only claim this medicine online on behalf of the patient.

From when till when can you submit a claim

Only declarations with a date from November 5 2020 can be submitted. For the Reimbursement Scheme of this medicine no closing date has been determined yet.

Submit a claim online

Patients and pharamcists can claim online and will receive the reimbursement within 5 working days.

Read our tips on how to submit a claim online

Login & Submit a Claim          

Open an Online Account (Patients) Open an Online account (Pharmacists)

Submit a claim by post

Patients can claim by post and will receive their reimbursement within 15 working days.

Tips on how to submit your claim by post

Please mail the Claim Form and attachments to:

TBR Nederland
Postbus 8011
1180 LA Amstelveen 

NL-6101 EXP 31/12/21
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