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Health economic modeling for medical technologies in Europe

Early and comprehensive economic models to determine economic value proposition and inform healthcare decision-makers

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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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2023-2024 Framework Contract entered into force in Romania

Romania operates using the Social Health Insurance (SHI) model. The Framework Contract defines the SHI benefits package, the conditions for providing services and payments. It was developed jointly by the National Health Insurance House (CNAS) and the Ministry of Health. Typically, it is updated every two years.

The "Application Norms of Framework Contract" and its annexes provide a detailed picture of the covered services. Furthermore, the annexes of the "Application Norms of Framework Contract" list the DRG cost weights and the tariffs for outpatient specialist services. It also contains the providers’ requirements to get the contract with the CNAS.

The changes in the updated Framework Contract cover primary care (new diagnostic and therapeutic services, including collection of biological samples for the Babes-Papanicolau test in symptomatic women or women planning a pregnancy, performing the Frax test, gastric lavage, etc.), outpatient specialist care (new diagnostic and therapeutic services, including optical coherence tomography for ophthalmology specialty, uroflowmetry for urology specialty, etc.), outpatient paraclinical care (eight new IVD tests, including serum transferrin, lactate dehydrogenase, etc.), imaging diagnostics (ten new services, including mammography with tomosynthesis, skin ultrasound, hip MRI, etc.), expanding the list of diagnostic and therapeutic medical services provided in the day case settings (62 new services were added to the list of day case services, including cardiac MRI as well as cardiac and peripheral Angio CT monitoring in patients with cardiovascular diseases, paracentesis, diagnostics and treatment of sleep apnea, etc. ), dental care, palliative home care. The summary of changes in the updated version of the Framework Contract can be found here.

The updated Framework Contract will be valid for the years 2023-2024. 

The full details in Romanian can be found 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). Contact us to get a free, three-month, no-obligation trial.