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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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2023/24 National Genomic Test Directory released in England

In April 2023, NHS England published an updated version of the National Genomic Test Directory for 2023/2024, which lists tests commissioned by NHS England via Genomic Laboratory Hubs. Three documents were published specifying tests codes, clinical indications, target genes, the technology by which tests are available, and eligibility criteria for patients:

  • National Genomic Test Directory for cancer (version 6);
  • National Genomic Test Directory for rare and inherited diseases (version 5);
  • Rare and inherited disease eligibility criteria (version 5).

Sixteen new codes (test-indication combinations) were introduced in the Test Directory for cancer. Some examples of the newly added codes are provided below:

  • M220.7 FGFR2 rearrangement FISH for cholangiocarcinoma;
  • M22.10 MYB rearrangement FISH/RT-PCR for diffuse astrocytoma (pediatric);
  • M93.6 Multi-target NGS panel-small variant (BTK, PLCG2, RAS, MAP2K1, BCL2) for lymphoma;
  • M181.5 Ig gene hypermutation detection NGS for hairy-cell leukemia non-classical variant;
  • M117.19 High Sensitivity BRAF for histiocytosis.

A total of 25 new codes (test-indication combinations) were added for rare and inherited diseases. Some examples of new codes are provided below:

  • R430.2 Exon level CNV (copy number variations) detection by MLPA (Multiplex ligation-dependent probe amplification) or equivalent (BRCA1, BRCA2, MLH1, MSH2, MSH6, ATM, PALB2, CHEK2) for inherited prostate cancer;
  • R440.2 Hereditary Diabetes Insipidus exon-level CNV detection by MLPA or equivalent (AVP; AVPR2; AQP2);
  • R15.5   Primary immunodeficiency or monogenic inflammatory bowel disease WES (whole exome sequencing);
  • R436.1 Hereditary alpha tryptasaemia targeted variant testing (TPSAB1);       
  • R441.1 Unexplained death in infancy and sudden unexplained death in childhood WGS  (whole genome sequencing).

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). Contact us to get a free, three-month, no-obligation trial.

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