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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 Belgian Health Care Knowledge Center published report for static automated external defibrillators for use by bystanders for out of hospital cardiac arrest

The Belgian Health Care Knowledge Center (KCE) released report of health technology assessment dedicated to static automated external defibrillators (AEDs) for use by bystanders. AEDs are not included into a coordinated public access defibrillation (PAD) programme. The aim of the report was to define if the government should support (also financially) the current practice or not (as currently most AEDs are privately owned). A second object of the assessment concerned the utility of the mandatory central registration of AEDs by the SPF Public Health.

For these purposes, a systematic literature search of health technology assessments and systematic reviews, complemented by search for Belgian data on applications of AEDs was performed. External experts and stakeholders were involved in review process to obtain critical appraisal of the proposed methodology and relevance of the report.

One HTA report that had been published by Ireland’s Health Information and Quality Authority (HIQA) was identified within the search. This report considered only one comparative study of the provision of static AEDs in public locations: the Public Access Defibrillation Trial.

Data on the number of AEDs in Belgium were extracted from the Federal Public Service (FPS) database. For statistics on out of hospital cardiac arrest (OHCA) and potential use of AED, data from the MUGREG/SMUREG registry were analyzed. However, available evidence suffered from severe limitations in relation to quality and completeness.

Additionally, current report contains information about legislation of AEDs and reveals requirements of installation and application of AEDs in Belgium. The current Belgian legislation recommends placing of AEDs in high risk public places.

Given the lack of robust evidence on the effectiveness of AED use by lay bystanders in public locations as well as the lack of robust Belgian data on current AED use, it was not possible to properly evaluate the cost-effectiveness impact of AED provision in Belgium. Therefore, no firm recommendation can be given regarding the provision of static AEDs to be used by bystanders in Belgium. In the same time, KCE suggested to utilize existing registries more efficient. Also, the importance of raising awareness about CPR in public and need of trainings was highlighted as a first step in the utilization of AED.

See full report in English here.

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