Deep brain stimulation

The French National Authority for Health (HAS) released new recommendations about add-on reimbursement of medical devices from the meetings of the National Commission for Evaluation of Medical Devices and Health Technologies (CNEDiMTS) in August 2024. Five recommendations were published concerning the registration of medical devices or modification of registration conditions/extension of indications for the medical devices in the List of Reimbursable Products and Services (LPPR). Opinions concern cardiovascular, peripheral vascular, neuromodulation, orthopedic, and spine devices.

On May 6, 2024, the Swedish Medical Technologies Product (MTP) Council commissioned the Dental and Pharmaceutical Benefits Agency (TLV) to perform a health economic evaluation of MR-guided focused ultrasound (Exablate Neuro) for the treatment of patients with essential tremor and Parkinson's disease. This evaluation is a part of the Orderly introduction framework, a staged process aimed at managing the national introduction of novel technologies. Based on the TLV assessment, the MTP Council will make recommendations to regions regarding the implementation of the technology and the criteria for use.

In early August 2023, the Polish Agency for Health Technology Assessment and Tariff System (AOTMiT) announced the start of the evaluation of several technologies in men’s health, neuromodulation and in-vitro diagnostics fields.

The French National Authority for Health (HAS) released new recommendations about add-on reimbursement of medical devices and medical aids from the meetings of the National Commission for Evaluation of Medical Devices and Health Technologies (CNEDiMTS) in July 2023. Sixteen recommendations were published in relation to the registration, modification of registration conditions, and renewal of registration for devices in the List of reimbursable products and services (LPPR). Opinions concern neuromodulation and surgical devices, as well as medical aids.

In January and February 2023, Ordering Forum for the “New Methods” framework invited interested parties regarding several technologies proposed for evaluation within the framework. The technologies concern arteriovenous fistula for hemodialysis, deep brain stimulation, epidural spinal cord stimulation, and digital chest drain. Ordering Forum will decide whether the technology undergoes evaluation at the national level.

For the first time in three years, the Institute for Quality and Efficiency in Health Care (IQWiG) received data within the framework of the early benefit assessment of new examination and treatment methods (NUB) with high-risk medical devices according to §137h of Social Code Book (SGB) V. This involves seven invasive therapeutic cardiovascular, pulmonary, neurological, gastrointestinal, and urological procedures.

In April 2021, the National Institute for Health and Care Excellence (NICE) published three new Interventional Procedure Guidance (repetitive short-pulse transscleral cyclophotocoagulation for glaucoma, deep brain stimulation for chronic, severe, treatment-resistant obsessive-compulsive disorder in adults, and Melphalan chemosaturation for primary or metastatic cancer in the liver) and two Medtech Innovation Briefings (microINR for anticoagulation therapy and RenalSense Clarity RMS for acute kidney injury), and two clinical guidelines (for atrial fibrillation and chronic pain in over 16s).

New codes for Prostatic Urethral Lift system, CT and MRI examination of the neck, fecal microbiota transplant, testicular sperm extraction, implantable rechargeable and a non-rechargeable pulse generator for deep brain stimulation, as well as PET-CT myocardial perfusion with volume, ejection fraction and flow measurements and molecular diagnostics, were implemented in 2020.

The French High Authority for Health (HAS) regularly publishes new decisions about add-on reimbursement for medical devices. The decisions made in April 2020 concern various types of devices, for example, cardiovascular and orthopaedic devices, diabetes management systems, and other types of devices. A total of 15 decisions were made.

The French High Authority for Health (HAS) regularly publishes new decisions about add-on reimbursement for medical devices. The decisions made in February 2020 concern various types of devices, for example, cardiovascular and orthopaedic devices, diabetes management systems, and other types of devices. A total of 27 decisions were made.

The report presents a summary of the reimbursement situation for deep brain stimulation. Indications include Parkinson’s disease, dystonia, essential tremor, cluster headache, and epilepsy. The analysis covers procedure coding, payment mechanism, reimbursement tariffs and policy restrictions in 11 EU countries including Austria, Belgium, Denmark, England, France, Germany, Italy, the Netherlands, Norway, Sweden and Switzerland.

The previous regional guidelines on brain stimulation therapy for advanced Parkinson’s disease, drug-resistant chronic migraine, and drug-resistant epilepsy, published in 2014, have been updated by the Regional Technical Commission for Medical Devices considering the new evidence on the specific groups of patients and some modifications in the indications for use of some devices. Check out indications for different neurostimulator technologies. These recommendations will form the foundation for reimbursement of devices in the region.