There is only one key theme describing market access for medical technologies in Slovakia:
- Reimbursement: payment mechanism via the DRG-adjusted budget system, add-on reimbursement, List of categorized special medical materials
Hospital care is predominantly financed via a budget adjusted for activity based on DRGs. Slovakia uses the SK-DRG system, which is based on the German DRG system. Thus, add-on reimbursement (based on Zusatzentgelt, ZE) is also a part of the DRG system, which is used to calculate the hospitals’ annual budgets. The base rate and the cost-weights of each DRG are determined at the national level.
SK-DRGs are determined by the combination of a procedure code (ZZV) and a diagnosis code (ICD-10-SK). The ZZV List and the SK-DRG system are maintained by the Center for Classification System (CKS-DRG) and are updated annually.
In addition, the Ministry of Health maintains a List of categorized special medical materials (ŠZM List), which is a list of explicitly approved brands of high-cost devices. The purpose of this List is to set maximum prices and the level of reimbursement for these devices; these devices are not reimbursed specifically but are purchased by the hospital from their annual budget. The cost of these devices is covered by the DRG system. Hospitals may also purchase devices not in the ŠZM List (uncategorized devices) and cover them from their budgets, but the administrative hurdles for purchasing these devices might be more complex.
How can MTRC help?
Development of reimbursement analysis (procedure coding, payment mechanism, reimbursement tariffs, policy and HTA considerations)
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