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Cost-effective reimbursement analysis for medical technologies in Europe

Procedure coding, payment mechanism, reimbursement tariffs, policy, and HTA considerations in 34 EU countries

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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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Changes in the reimbursement of outpatient surgeries in 2024 in Germany

On December 20, 2023, the National Association of Statutory Health Insurance Funds (GKV-Spitzenverband) announced that from January 1, 2024, the catalog for ambulatory operations in hospitals (AOP catalog) will be significantly expanded – 171 interventional procedures will be included in the catalog.

Together with the first expansion of the AOP catalog, which has been in effect since the beginning of 2023, in 2024, there would be a possibility to provide, in total, 3,312 services on an outpatient basis in hospitals or by physicians in private practices. At the same time, this step supports the upcoming hospital reform as more outpatient surgeries relieve pressure on both staff and bed capacities in the hospitals.

Also, the AOP contract, which regulates the conditions of the provision of ambulatory operations in hospitals, was updated. It will come into force on January 1, 2024. The contract was supplemented by defined urological material costs (§ 9 paragraph 5 of the AOP contract). The other existing regulations for reimbursing material costs remain unchanged.

The full details in German can be found here and here.

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.