There are two key themes describing market access for medical technologies in Wales:
- Funding: development of commissioning policies, inclusion of services in the List of commissioned services
- Health technology assessment: obtaining recommendations from Health Technology Wales (HTW)
Wales operates under the global budget principle; there is no reimbursement system in place. However, the HRG system does exist, and it is not used for reimbursement but only for costing purposes and allocation of financing to (disease-defined) program budget categories by individual Local Health Boards. Wales uses the same UK HRG system as England.
Funding is the key aspect of market access in Wales. While routine hospital care is organized and provided by Local Health Boards of NHS Wales, specialized services require specific commissioning policies, and inclusion in the List of commissioned services. The designation of specialized services is made by the Welsh Health Specialized Services Committee (WHSSC).
Health technology assessment
HTAs are performed on the national level by Health Technology Wales, and their recommendations significantly influence the adoption of novel technologies by healthcare providers and the designation of specialized services.
Specifics for IVD tests
There is no specific reimbursement framework for in-vitro diagnostic tests. Most IVD tests are funded using a global budget principle as part of the funding of the labs.
Genetic and molecular pathology tests are regulated by the All Wales Medical Genomics Service (AWMGS).
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