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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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CRP rapid test shows promising results for the reduction of antibiotics use in Germany

The insurance company AOK Saxony-Anhalt concluded that patients are much less frequently prescribed an antibiotic after the examination via a rapid test for a bacterial cause of the infection. In more than 40% of the tested patients, the doctors waived the antibiotics prescription.

Primary care providers are responsible for the majority of antibiotic prescriptions, and the highest overall number of such prescriptions are issued by family physicians. There is a reason to believe that many of these prescriptions could be avoided. Unwarranted use of antibiotics drives antimicrobial resistance, wastes resources, may cause adverse effects, negatively affects the microbiome of patients, and distracts from potentially more effective interventions. Point-of-care tests for acute infections are being promoted by government organizations, the industry, and clinical guidelines to target antibiotic prescribing better, help contain antimicrobial resistance, and improve patient outcomes.

The CRP (C-reactive protein) rapid test has been used for the examination of the AOK insured about 30,000 times since March 2018. The AOK appealed to general practitioners (GPs) and specialists to use the test more frequently providing additional reimbursement in a case when the physicians examined the insured of the AOK Sachsen-Anhalt and the IKK Gesund plus.

The aim of the project, which was initiated with the support of the Association of Statutory Health Insurance Physicians (KV) and the Association of General Practitioners in Saxony-Anhalt, is to improve the diagnosis of the prescription of antibiotics.

These services are "not in a fee order item" of the EBM (Einheitlicher Bewertungsmaβstab, German Uniform Evaluation Standard) and therefore are not comparable with the existing EBM positions for the CRP tests reimbursement. The Association of General Practitioners in Saxony-Anhalt emphasized that rapid CRP-test as a laboratory service could so far be billed by the GPS and specialists via the EBM.

Therefore, so far, the CRP rapid test is not one of the standard services for acute infection for statutory health insurance. The AOK takes over the costs as part of its AOK GP and pediatrician contract.

The full details in German can be found here.

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