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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 Norwegian DRG system released

29 Dec 2022

On December 21, 2022, the Norwegian Directorate of Health published the final version of the DRG system (Innsatsstyrt finansiering, ISF) for 2023. ISF is activity-based funding to the regional health authorities (Regionale Helseforetak, RHF) through the national budget. The financing of the RHFs is mainly two-fold and consists of a basic grant and activity-based funding. For 2023, activity-based funding for somatic specialist healthcare is about 40%, and the basic grant is about 60%.

The Norwegian DRG system (ISF) consists of three parts:

  • Diagnosis-related groups (DRG);
  • Special Service Groups (Særtjenestegrupper, STG), which cover specialist health services that take place in other than traditional inpatient and outpatient settings, as extended over a long period of time so that the patient himself is more responsible for the administration of the treatment (e.g., patient-administered peritoneal dialysis or hemodialysis, telemedicine);
  • Service Course Groups (Tjenesteforløps grupper, TFG), which refer to "bundled payments," so it is an aggregated level above DRG and STG, providing financing of a patient treatment course with several stays and activities (e.g., dialysis treatment, insertion of hip prostheses).

Eight new DRGs concerning endocrinology, surgical procedures, infection diseases, genetics, and the general area will be added in 2023. Some examples are provided below:

  • 291 “Diabetes 0-17 years” (replaces DRG with the age limit of 35 years);
  • 505 “Major or complicated breast reconstruction”;
  • 928O “Genetic guidance”.

More significant changes were made in the STG system, with the creation of 23 new codes related to digital home monitoring, collaborative activities, medical quality registers, and drug treatment.

Two new TFGs related to HIV treatment and ophthalmology will be introduced in 2023.

In 2023, to obtain DRG/STG/TFG tariffs for somatic care, cost-weights must be multiplied on a base tariff of 49,484 NOK.

See more information in Norwegian 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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