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Evidence gap analysis

Strategic analysis of the sufficiency of evidence to obtain reimbursement and HTA approval in Europe and recommendations about evidence generation

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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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2024 APR-DRG system released in Belgium

On January 15, 2024, the National Institute for Health and Disability Insurance (INAMI-RIZIV) released an updated DRG system for 2024. This “Low Variability Care” system was first introduced in 2019. It is used for certain low-cost and non-complex procedures, which are reimbursed via APR-DRG groups instead of individual physician fees. Unlike in other countries, the APR-DRG tariff does not cover materials and ward stays. 

No significant changes were made in the 2024 release. No new APR-DRGs were added; thus, the total number of APR-DRGs remains the same as in 2023 (61). The reimbursement tariffs were increased by about 5%.

See the full details here (reimbursement tariffs) and here (DRG logic).

This news is just one of about 300 market access news collected by our team in the premium subscription service Market Access Monitor every week from more than 80 organizations. Access our paid service to stay on top of all developments specifically for your products in Europe (reimbursement news) and globally (HTA news). Access is organized as an online Database and email alert formats. Contact us to get a free, three-month, no-obligation trial.