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Reimbursement summary for angioplasty of arteries of lower extremities

This post presents an extract from our reimbursement analysis for angioplasty of arteries lower extremities using plain and drug-coated balloons (DCBs) for peripheral artery disease in England, France and Germany. Plain balloon angioplasty is reimbursement via DRG solely and DCBs are reimbursement via combination of DRG and add-on reimbursement.
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National tariffs for outpatient specialist and prosthetic care postponed until 2025 in Italy

The Essential Levels of Care (LEA) document from 2017 defines the guaranteed basket of benefits for the Italian population. Annex 4 of the LEA document contains a fee-for-service list of outpatient specialist services (including IVD tests) guaranteed on the national level. Annex 5 of the LEA document contains the nationally guaranteed medical aids and prostheses.

Although the LEA document was brought in 2017, the services did not have relevant national tariffs established. So far, the only national tariffs (used by the Regions as a reference for developing regional tariffs, which are actually used for reimbursement of services) were from 2012.

After the draft decree defining the reimbursement tariffs for the 2017 LEA catalog submitted to the State-Regions Conference in January 2022 was rejected, a new draft decree was presented in September 2022. Eventually, in April 2023, the Italian Ministry of Health announced that the State-Regions Conference approved the national tariffs for outpatient specialist care and prosthetic care.

In August 2023, the tariffs for the 2017 LEA were updated. The new tariffs for outpatient specialist care were expected to enter into force on January 1, 2024 (later postponed to April 1, 2024); the new tariffs for prosthetic care were supposed to enter into force in April 2024. In late December 2023, the Italian Ministry of Health postponed adopting new national LEA tariffs for outpatient specialist services and medical aids until April 1, 2024.

However, on March 27, 2024, a new Decree of the Italian Ministry of Health on the effective date for the National LEA catalog was announced to be ready for submission to the State-Regions Conference. The primary purpose of the Decree is to postpone the adoption of new national LEA tariffs for outpatient specialist services and medical aids until 1 January, 2025. As the Minister of Health announced, the new tariffs need to be revised again.

See full details in Italian here.

This news is just one of about 300 market access news collected by our team in the premium subscription service Market Access Monitor every week from more than 80 organizations. Access our paid service to stay on top of all developments specifically for your products in Europe (reimbursement news) and globally (HTA news). Access is organized as an online Database and email alert formats. Contact us to get a free, three-month, no-obligation trial.