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Knowledge Zone

Brief summaries of the market access landscape for medical technologies and in-vitro diagnostic tests in European countries

Austria

Reimbursement (MEL coding, DRG system), innovative payment scheme (NUB) and HTA (AIHTA) 

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Belgium

Reimbursement (INAMI Nomenclature, List of reimbursable implants and invasive devices, DRG system) and innovative payment scheme (Application Clinique Limitée) 

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Bulgaria

Reimbursement (KSMP coding, case payment categories, add-on reimbursement)

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Croatia

Reimbursement (List of surgical and medical procedures, DRG-adjusted budget)

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Czech Republic

Reimbursement (SZV coding, CZ-DRG system, List of separately reimbursed materials)

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Denmark

Reimbursement (SKS coding, DRG system), funding (national recommendations from the Health Technology Council), health technology assessment

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England

Reimbursement (OPCS coding, National Tariff, HRG System), funding (NHS England, Integrated Care Boards) and HTA (NICE)

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Estonia

Reimbursement (NCSP coding, DRG system, List of covered services)

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Finland

Reimbursement (THL coding, DRG system, regional price lists), funding (recommendations by the national Council for Choices in Health Care)

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France

Reimbursement (CCAM coding, DRG System, add-on reimbursement via LPPR List, innovative payment schemes)

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Germany

Reimbursement (OPS coding, DRG System, add-on reimbursement, innovation funding via NUB, EBM catalog), funding (G-BA Directives)

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Greece

Reimbursement (Greek Medical Procedure Classification, Greek DRG system, separately paid devices)

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Hungary

Reimbursement (OENO coding, DRG system, Separately paid devices, fee-for-service mechanism), funding (coverage decisions by the National Health Insurance Fund)

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Italy

Reimbursement (ICD-9-CM coding, DRG System, add-on reimbursement and DRG split), HTA (AGENAS and regional bodies)

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Ireland

Reimbursement (Australian Classification of Health Interventions, DRG-adjusted budget, block grants), HTA (Health Information and Quality Authority)

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Latvia

Reimbursement (NCSP coding, DRG system, case-payments, fee-for-service)

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Lithuania

Reimbursement (Australian Classification of Health Interventions, DRG system, add-on reimbursement, Medical services pricelists)

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Luxembourg

Reimbursement (Nomenclature of physician services, global budget model)

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Netherlands

Reimbursement (procedure coding, DRG system), funding (coverage positions by the Dutch Healthcare Institute)

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Norway

Reimbursement (NKPK coding, DRG system), funding (coverage decisions in the national “New Methods” framework)

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Poland

Reimbursement (ICD-9-PL procedural classification, DRG system, fee-for-service) 

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Portugal

Reimbursement (ICD-10-PCS coding, DRG system, fee-for-service tariffs, separately accounted devices)

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Romania

Reimbursement (Romanian Nomenclature of procedures, DRG system, Coverage in the Curative National Programs for complex procedures)

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Scotland

Funding (inclusion in the List of national specialist services) and HTA (Scottish Health Technologies Group)

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Slovakia

Reimbursement (SZV coding, SK-DRG system, add-on reimbursement, List of categorized special medical materials)

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Slovenia

Reimbursement (List of therapeutic and diagnostic procedures, DRG system, List of separately billed materials)

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Spain

Funding (package of benefits provided within the NHS), HTA (Instituto de Salud Carlos III and regional bodies)

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Sweden

Reimbursement (KVÅ coding, DRG system), funding (recommendations in the national “Orderly Introduction of Medical Technologies” framework)

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Switzerland

Reimbursement (CHOP coding, DRG system, add-on reimbursement), funding (coverage decisions by the Federal Office of Public Health)

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Turkey

Reimbursement (SUT procedure coding, SUT material codes)

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Wales

Funding (NHS Wales), HTA (Health Technology Wales)

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