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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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Consultation on 2021/22 National Tariff Payment System is now open in England

08 Apr 2021

On March 22, 2021, NHS England and NHS Improvement released 2021/22 National Tariff Payment System (NTPS) consultation documents and launched an online feedback survey that closes on April 30, 2021.

The principal proposal for the 2021/22 NTPS is to Introduce a new "Aligned Payment and Incentive" (API) approach for almost all services in the tariff scope. During the engagement on proposals for 2021/22, the payment approach was described as blended payment. However, there was some confusion about how the proposals related to the blended payments introduced in previous years. The NHS wants to be clear that the current proposals (API) are significantly different from the last blended payment model.

API includes a fixed element of payment, a variable element (relating to the volume of elective inpatient, day case, and outpatient procedure activity), and a quality-related element (Best Practice Tariffs and Commissioning for Quality and Innovation, CQUIN). CQUIN funding is, therefore, transferred into the NTPS.

Another significant amendment is that national prices are now limited to unbundled diagnostic imaging services (i.e., diagnostic imaging not part of an inpatient spell). All other prices are calculated and published as unit prices.

A target date for the NTPS to come into effect is not defined yet. The NTPS could be published later in 2021/22 when it is decided to end the measures related to COVID-19.

See consultation documents, annexes, supporting documents here, online survey here

This news is just one of about 300 market access news collected by our team in the subscription services "HTA Alerts" and "Reimbursement Alerts" every two weeks from more than 80 organizations. Access our paid subscription services to stay on top of all developments specifically for your products in Europe (reimbursement news) and globally (HTA news). First EU issues of both newsletters are available for download free-of-charge.

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