The results of this study indicate that the present regulatory system is not sustainable. The RIVM study also indicated that the four themes are closely interrelated, with a change in one theme always having an effect on the others. While more flexible regulations to stimulate innovation enable pharmaceuticals to be released to the market sooner, there is less knowledge about the safety of a medicine when approval is granted. Additional safety regulations lead to longer clinical trials and thus to higher costs for the development of medicines and more limited availability.

The interests of the various parties (patients, pharmaceutical industry, health insurers, health care professionals and society as a whole) are difficult to balance to the satisfaction of all parties. Seriously ill patients with diseases for which no treatment is available appear to be willing to accept more risks in terms of safety and efficacy so that a medicine can be made available sooner. In addition, factors external to the regulatory system can have an impact on the four themes, such as commercial interests (forecasts of the financial return on a medicine to treat a rare disease) and decision making on reimbursement for medicines (a national matter).