There is only one key theme describing market access for medical technologies in Croatia:
- Reimbursement: payment mechanism via the DRG-adjusted budget system
Hospital care is financed via a global budget adjusted for activity based on DRGs.
DRGs are determined by the combination of a procedure code (List of surgical and medical procedures, an adjustment of the Australian ACHI classification) and a diagnosis code (ICD-10). The procedure coding list and the DRG system are maintained by the Croatian Health Insurance Fund (CHIF), but the possibilities for establishing new codes and DRGs are limited. DRG cost weights are updated annually.
Additional payments for very expensive drugs/devices do exist. While there is a specific list of expensive drugs that the CHIF can cover, for medical devices, individual hospitals must reach out to CHIF and ask to cover the costs every time they want to purchase expensive technologies via public tenders.
Specifics for IVD tests
In-vitro diagnostic tests provided in ambulatory settings are reimbursed on a fee-for-service basis via the List of Diagnostic-Therapeutic Procedures (DTPs), maintained by the Croatian Health Insurance Fund.
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