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Reimbursement

23
May 2024

PECAN tariffs for digital medical devices with therapeutic function released in France

On April 25, 2024, the Ministry of Labor, Health, and Solidarity published an Order in the Official Journal of the French Republic setting the tariffs for digital medical devices with therapeutic functions covered within the early digital support (PECAN) scheme. The tariff for the manufacturer will include an initial lump sum of €435 per patient billable for up to 3 months and a subsequent monthly package of €38.30. The maximum amount of financial compensation is €780 per year per patient.
17
May 2024

2025 HAS work program applications announced in France

On April 18, 2024, the French National Authority for Health (HAS) announced the submission of requests for registration in the 2025 HAS Good Practice Recommendations Work program – for professional organizations and in the 2025 HAS Work program – for patient associations.
16
May 2024

Changes in laboratory analyses tariff setting in Switzerland

On May 1, 2024, the Swiss Federal Council adopted a message to amend the Federal Health Insurance Act (KVG) following a parliamentary mandate, which requires a change in how tariffs for laboratory analyses are determined. Instead of being set by the Federal Department of Home Affairs (FDHA), the tariffs of tests in the List of Analyses will be determined through negotiations between collective bargaining partners, streamlining the inclusion of innovative analyses and slowing down the increase in healthcare costs.
30
Apr 2024

2024 DRG tariffs published in France

On April 18, 2024, the Ministry of Labor, Health, and Solidarity published the Order in the Official Journal of the French Republic, setting DRG tariffs and tariffs for other packages and supplements for 2024. New tariffs are applicable from March 1, 2024.
22
Apr 2024

Decree relating to the RIHN framework reform published in France

On March 31, 2024, the Ministry of Labor, Health, and Solidarity published a Decree in the Official Journal of the French Republic relating to the conditions of coverage of innovative IVD tests within the RIHN framework, which should facilitate the transition from the RIHN framework to regular reimbursement via the NABM Nomenclature.
17
Apr 2024

Intra-DRG list updated in France

On April 8, 2024, the updated version of the intra-DRG list of April 6, 2024, was published. One new device was registered, and other changes concerned modifying the registration conditions and renewing registration or extending the registration.
02
Apr 2024

National tariffs for outpatient specialist and prosthetic care postponed until 2025 in Italy

The Essential Levels of Care (LEA) defines outpatient specialist and prosthetic care guaranteed to the Italian population. Although the LEA document was brought in 2017, the national tariffs for outpatient specialist and prosthetic care were launched in April last year after seven years of development. They were supposed to come into effect on January 1, 2024 (later postponed to April 1, 2024). However, on March 27, 2024, the need for tariff revision and the new Decree postponing the tariffs until January 2025 was announced by the Italian Ministry of Health
18
Mar 2024

New emergency care supplements released in France

On March 1, 2024, the updated Benefit Order was published in the Official Journal of the French Republic. Notable updates encompass modifications to existing emergency care supplements and the addition of new ones for non-hospitalized emergency care services, such as laboratory tests, imaging, specialist consultations, out-of-hours care, and specific provisions based on patient condition and age.
08
Mar 2024

Tariffs for medical telemonitoring activity for patients with defibrillators and cardiac pacemakers released in France

On February 28, 2024, the Ministry of Labor, Health, and Solidarity published an Order in the Official Journal of the French Republic setting the tariffs for the medical telemonitoring activities for patients with defibrillators and cardiac pacemakers. The half-yearly tariff for the distributor of digital medical devices is set at €550 per patient for the first 4,999 patients.
20
Feb 2024

Three more health apps obtained reimbursement in Germany

Between mid-January 2024 and mid-February 2024, three more health apps were introduced in the Directory of digital health applications (DiGAs) at the Federal Office for Drugs and Medical Devices (BfArM) and thus became reimbursable. These apps can be prescribed by physicians and psychotherapists and will be reimbursed by health insurers. In total, 56 health apps are currently available in the DiGA Directory, and six health apps were delisted from the Directory.
19
Feb 2024

Five-year implementation strategy for Hybrid closed loop technologies in England

On January 22, 2024, NHS England published a 5-year implementation strategy for Hybrid closed loop (HCL) technologies following the NICE technology appraisal (TA943) publication. As a rule, commissioners and providers must implement TA recommendations within three months. However, an agreed five-year implementation will allow NHS to build specialist competencies and cost-effective procurement. NHS England will fund integrated care boards to reimburse the use of HCL systems