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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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The 2025 version of the SwissDRG released

On December 12, 2024, the entity managing the DRG system in Switzerland, SwissDRG, published the final (billing) version of the 2025 DRG system. In total, 23 new DRGs were introduced, and they concern cardiovascular, endoscopy, ENT, gastrointestinal, nephrology and urology, neurology and neurosurgery, obstetrics and gynecology, orthopedics, peripheral vascular, pulmonary and airways, and spine areas. Some examples of the newly introduced DRGs are the following:

  • F02Z Generator replacement of a cardioverter/defibrillator (AICD), dual- or triple-chamber stimulation;
  • G46D Gastroscopy, colonoscopy, or endoscopic antireflux procedures, more than one day of hospitalization;
  • D86A    Diseases and disorders of the ear, nose, mouth, and throat with specific procedures, one day of hospitalization;
  • H07D    Cholecystectomy, age > 11 years;
  • B61F Paraplegia/tetraplegia or spinal cord injuries with surgical intervention;
  • N04D Hysterectomy, oophorectomy, or complex procedures on the fallopian tubes, except for malignant neoplasms;
  • E64D Respiratory insufficiency or pulmonary embolism, age > 15 years;
  • I09F Vertebral body fusion or vertebral body replacement with at least two implants.

Also, 17 new add-on reimbursement categories related to nephrology and urology, neurology and neurosurgery, radiotherapy, and peripheral vascular fields were introduced.

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.