Bariatric surgery

In June 2023, the National Institute for Health and Care Excellence (NICE) published one new Interventional Procedure Guidance (irreversible electroporation for treating prostate cancer) and one new Diagnostic Guidance (AI-derived computer-aided detection (CAD) software for detecting and measuring lung nodules in CT scan images). Also, three clinical guidelines were updated.

In June 2023, the Clinical Coding and Schedule Development (CCSD) working group, which develops and maintains procedural and diagnostics nomenclatures for private payers in England, published Bulletins 190 and 086 with changes to be implemented no later than August 4, 2023. Fourteen new procedure codes (concerning cardiovascular, diagnostic imaging, endocrine, endoscopy, gastrointestinal, orthopedic and spine, peripheral vascular, robotic surgery, men's health, and radiotherapy fields) and six new diagnostic codes were introduced.

On May 31, 2022, the French National Authority for Health (HAS) published the final positive opinion on the coverage of the endoscopic gastroplasty with the ENDOMINA triangulation platform under the Innovation package (Forfait innovation).

On April 25, 2022, the Decision Forum for "New Method" did not prioritize any surgical procedure in the treatment of morbid obesity. Available evidence in the complete method assessment shows minor or no difference in weight loss, diabetes control, or health-related quality of life when using various surgical procedures. The comparative effect on the risk of early mortality, progression of obesity, and obesity-related comorbidities was not possible to determine. The cost differences are non-significant. Further research was recommended.

On January 20, 2022, the Academy of Medical Royal Colleges (AoMRC) launched a consultation on the latest set of guidance (List 3) of the Evidence-based Interventions (EBI) Programme. EBI program develops guidance sets (Lists) for tests, treatments, and procedures based on recommendations from the Expert Advisory Committee and NICE assessments. Proposed List 3 covers 17 interventions across a range of medical specialties, including cardiology, ophthalmology, urology, and others. The deadline for comments submission is March 31, 2022.

At the beginning of August 2021, the European Network for Health Technology Assessment, EUnetHTA, released a final report on the surgical procedures for the treatment of obesity. The results suggest little or no difference in the effects of different bariatric surgery procedures on weight loss and diabetes control. However, the results are based mainly on low to very low certainty evidence, with few or even single studies providing data for many of the comparisons.

In July 2021, the Austrian Institute for Health Technology Assessment (AIHTA) published six new decision support documents and one update to a previous decision support document. The assessed topics included percutaneous left ventricular assist devices, liposuction for surgical therapy of lipoedema, triphasic biomaterial for augmentation of the osteoporotic femoral neck, endoscopic plication therapy in patients with gastroesophageal reflux disease (GERD), allogenic bone screw Shark Screw® in patients with hallux valgus or scaphoid fractures/pseudarthroses, and surgical interventions for the treatment of benign prostatic hyperplasia. The updated decision support document concerned implantable bulking agents for fecal incontinence.

The French Ministry of Solidarity and Health constantly announces the new experiments initiated under Article 51 of the Social Security Financing Act. These experiments are focused on various topics concerning medical technologies and organization of care. Eleven new experiments were initiated in the fourth quarter of 2020. The experiments concern areas of diabetes, nutrition, home monitoring of patients on oral cancer drugs, bariatric surgery, and others. More details about each of the experiments initiated in the fourth quarter of 2020 is provided in this article.

On October 15, 2020, the French National Authority for Health (HAS) published the report “New techniques of bariatric surgery: identification, the status of advancement and opportunities to evaluate,” in which they outlined three techniques currently diffusing in France (SADI-Sleeve, Endosleeve, and Sleeve Gastrectomy with Transit Bipartition). All three methods are the subject of ongoing clinical studies, and the evaluation will be initiated at the end of these studies.

In August 2020, the network of European HTA agencies, EUnetHTA, announced the final plan of the project OTCA26 “Surgical procedures for treatment of obesity.” The key question of the assessment is bariatric surgery for the treatment of adults with obesity.

In early September 2019, the Innovation Committee of the Federal Joint Committee (G-BA) has published an overview of new research projects in the area of health services to be funded by the Innovation Fund in the future.

In September 2019, the French High Authority for Health (HAS) released an assessment report for gastric bypass, also known as omega loop in severe obesity. The evaluation aimed to compare omega-loop gastric bypass (OLGB) with Roux-en-Y Gastric Bypass (RYGB) in terms of efficacy and safety. OLGB cannot be determined as an alternative treatment to RYGB considering the safety aspects due to a lack of efficacy and safety data. The method should be studied in a framework of clinical research.