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Reimbursement summary for angioplasty of arteries of lower extremities

This post presents an extract from our reimbursement analysis for angioplasty of arteries lower extremities using plain and drug-coated balloons (DCBs) for peripheral artery disease in England, France and Germany. Plain balloon angioplasty is reimbursement via DRG solely and DCBs are reimbursement via combination of DRG and add-on reimbursement.
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2022/23 MedTech Funding Mandate policy published in England

28 Mar 2022

In March 2022, NHS England and NHS Improvement Accelerated Access Collaborative published the MedTech Funding Mandate (MTFM) policy for 2022/23, which will come into force on April 01, 2022. The MTFM launched in 2021 to support NICE-approved and cost-saving devices, diagnostics, and digital products.

The MTFM does not directly fund the technologies included in the policy, and they will be reimbursed locally by Clinical Commissioning Groups (CCG) from their existing allocations. This is because the technologies meet the criteria to save costs and resources and make a return on investment within three years. MTFM technologies are listed in the National Tariff Payment System Annex A (Innovative products list), noting that these items are excluded from HRG (DRG) tariffs.

Technologies that meet the following criteria will be supported by 2022/23 MTFM:

  • Effective: demonstrated through positive NICE Medical Technology Guidance (MTG) or Diagnostic Guidance (DG), published by June 30, 2021;
  • Cost-saving within three years of implementation: as demonstrated by NICE modeling and published in a NICE resource impact template;
  • Affordable to the NHS: the NICE budget impact analysis total costs should not exceed £20 million in any of the first three years.

MTFM technologies are reviewed annually to ensure that they meet the policy criteria. Four technologies included in 2021/22 (placental growth factor-based testing, SecurAcath, HeartFlow, gammaCore) will continue to be supported. Seven new technologies are added in 2022/23: four for benign prostatic hyperplasia treatment (UroLift, GreenLight XPS, Rezum, and PLASMA system), and three for improving the patient experience during procedures (XprESS multi-sinus dilation system, Thopaz+, and Spectra Optia).

See the full details here.

This news is just one of about 300 market access news collected by our team in the subscription services "HTA Alerts" and "Reimbursement Alerts" every two weeks from more than 80 organizations. Access our paid subscription services to stay on top of all developments specifically for your products in Europe (reimbursement news) and globally (HTA news). First EU issues of both newsletters are available for download free-of-charge.

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