Skip to main content
See details

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.
See details

2022/23 National Tariff Payment System came into force on April 01, 2022 in England (National Health Service, NHS)

11 Apr 2022

On March 31, 2022, NHS England and NHS Improvement (NHSE/I) released the 2022/23 National Tariff Payment System (NTPS) to come into force on April 01, 2022. The key changes are presented below:

  • The aligned payment and incentive (API) model remains the central part of the 2022/23 NTPS, covering almost all secondary healthcare services. API applies to all contracts for secondary healthcare services between a commissioner and providers who are members of the same Integrated Care System (ICS) or from different ICSs if an expected annual contract value of £30 million or more
  • The API comprises a fixed element, based on funding an agreed level of activity and reflecting plans for 2022/23, and a variable element to reflect actual achievement of best practice tariff (BPT) and Commissioning for Quality and Innovation (CQUIN) criteria;
  • The initial fixed element must reflect the assumed full achievement of CQUIN metrics and BPT criteria. Actual performance should then be tracked during the year, with funding increased or recouped in line with actual achievement;
  • There are some exceptions where the API approach does not apply, for example, where the contract is between a provider and commissioner from different ICSs, and the contract value is less than £30 million. Payment arrangements would be determined by a local agreement between the commissioner and the provider. If a local agreement is not possible, HRG tariffs would be used as a default;
  • NHSE/I used patient-level cost data (PLICS, 2018/19) instead of reference cost for the first time to calculate 2022/23 tariffs;
  • Four new device categories were included (Wireless pacemaker, Endobronchial valve, SpaceOAR Hydrogel, Mechanical thrombectomy stent retrievers and clot retrievers) and two existing categories (peripheral nerve stimulator, sutureless aortic heart valve / rapid deployment aortic heart valve replacement)  were updated to cover more devices in the 2022/23 High Cost Device List (Annex A, tab 14a). In 2022/23, all High Cost devices are excluded from the fixed element and funded on a cost and volume basis;
  • Innovative products (Annex A, tab 14c) covered by the MedTech Funding Mandate are excluded from the HRG tariff and paid outside of the fixed element, although funding for implementing them is included within the fixed element. Seven new technologies are added to the list in 2022/23.

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.

Not ready for a subscription service? Subscribe to our free-of-charge newsletter delivered every second week to get updates about key reimbursement developments in Europe (10-12 news every two weeks).