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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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Depression will be treated within the Disease Management Program in Germany

Patients suffering from recurrent or long-lasting depression can be treated within a structured treatment program (Disease Management Program, DMP) in the future. The Federal Joint Committee (G-BA) decided on the 15th of August 2019 the details on the content of the new DMP after more than three years of consulting.

The main points outlined in DMP for depression include the definition of the treatment offer target group, the therapy goals, and planning as well as recommendations for the therapeutic measures. Patients can be enrolled in the program after the statutory health insurance funds will conclude contracts with physicians and/or hospitals for the practical implementation of the DMP.

The DMP is aimed at patients with from moderate to severe chronic depression or recurrent depressive episodes. The simultaneous presence of mental or physical illnesses, such as anxiety disorders, alcohol dependence, tumors or diabetes mellitus, is explicitly not an exclusion criterion for participation in DMP - due to the importance of comorbidities in depression, the adequate diagnosis and treatment of comorbidities as an independent therapeutic target in the DMP is added. On the other hand, if depression occurs as a result of an underlying physical illness, enrolling in the DMP is not possible, as here the treatment of the underlying disease is in the foreground. Participation in the DMP can, however, take place if the depression is considered as comorbidity.

The inclusion and exclusion criteria for enrollment in the DMP depression will be examined by family doctors or specialized care providers, for example, specialists in psychiatry and psychotherapy.

The DMP identifies a range of therapeutic goals that should be discussed with the patient and determined individually, such as the reduction of depressive symptoms with the aim of complete remission of the disease and the improvement of psychosocial skills to support a self-determined lifestyle.

The therapeutic measures will be planned individually taking into account the defined therapeutic goals: the patient will decide on the treatment together with the doctor. The choice of therapeutic interventions will depend on the severity of the depression, the previous course of the disease, any psychic and physical comorbidities as well as the age.

Because of the increased risk of suicide in people with depression the patient check for possible suicidal tendencies in the course of the diagnosis as well as in the course of treatment and if necessary, the initiation of concrete supporting measures are included in the DMP as well.

The scientific basis of the new DMP is, in particular, the guideline synopsis for a DMP Depression provided by the Institute for Quality and Efficiency in Health Care (IQWiG), published in April 2017. IQWiG was assigned this task by the G-BA in August 2015.

The G-BA is now submitting the resolution to the Federal Ministry of Health (BMG) for examination. After non-objection, the requirements for the DMP Depression will come into effect on the first day of the quarter after the publication in the Federal Gazette.

The DMP requirements for osteoporosis and rheumatoid arthritis are also currently being developed.

The full details in German can be found here.

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