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Market access for medical technologies in Austria

A brief overview of key market access pathways and challenges for medical devices, in-vitro diagnostic tests in Austria

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Key topics

There is only one key theme describing market access for medical technologies in Austria: 

  • Reimbursement: payment via DRG-adjusted budget.
     

There are no separate funding (approval by the payer) or health technology assessment challenges in Austria. HTA (by the Austrian Institute for Health Technology Assessment) is integrated into reimbursement decision-making. 

Austria has one innovative payment scheme for medical technologies (NUB, provisional coding for medical procedures). 

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Reimbursement

Austrian hospitals are funded using a budget adjusted for activity based on DRGs.

DRGs are defined by a combination of:

  • Diagnosis codes (International Classification of Diseases; ICD-10)
  • Procedure codes (Austrian Individual medical procedure; MEL)
  • Patient-specific parameters (e.g., age, length of stay, sex)

The combination of codes and patient characteristics will result in a specific DRG associated with points (cost weight). These DRG points are multiplied with a monetary base rate that differs between states and even hospitals within states. Cost weights are determined on the basis of the micro-costing method using data from selected reference hospitals.

There is no add-on reimbursement for medical devices or procedures. 

Innovative procedures with insufficient clinical evidence to justify the creation of the regular procedure (MEL) code can receive registration as provisional procedure codes (NUB). Provisional procedure codes do not attract additional or higher reimbursement vs standard treatment. 

An updated version of the LKF catalog is released by the Federal Ministry of Social Affairs, Health, Care, and Consumer Protection annually. It comes into effect on January 1st of each calendar year. 

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Specifics for IVD tests

There is no specific reimbursement framework for in-vitro diagnostic tests, which are performed within specialist care settings. Most IVD tests are funded using a global budget principle as part of the funding of the labs. 

Simple IVD tests, which can be ordered by primary care physicians, can be reimbursed via fee schedules, developed by individual sickness funds. 

MTRC has experience with more than 115 projects in Austria

News and insights

12 Jan 2024

Rapid reviews of two health technologies published in Austria in December 2023

In December 2023, the Austrian Institute for HTA published Rapid reviews of two health technologies: endovenous laser therapy for varicose veins of the lower extremities and autologous fat transplantation for osteoarthritis.
31 Oct 2023

Austrian Federal Ministry of Social Affairs, Health, Care and Consumer Protection (BMSGPK) sets priorities in 2024 health reform

On October 18, 2023, the Austrian Federal Ministry of Social Affairs, Health, Care and Consumer Protection (BMSGPK) announced that its budget would increase by 3.9 billion to 25.8 billion euros (by 18%) in the coming year. 1.1 billion euros from the budget will be allocated for the health care reform, which will be implemented as part of the financial equalization.
02 Aug 2023

New med tech-related decision support documents published in Austria

On July 17, 2022, the Austrian Institute for HTA (AIHTA) published four decision support documents, which provide recommendations regarding the inclusion of new medical interventions in the catalog of individual medical services of the performance-oriented hospital financing (Leistungsorientierten Krankenanstaltenfinanzierung, LKF) model, as well as three updates to previous decision support documents.

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