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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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Dutch Healthcare Institute published an annual report on the progress of the conditional reimbursement program in 2020

29 Apr 2021

Since January 1, 2012, the Minister for Health Care and Sport can decide on the temporary inclusion of medical technologies that have not yet been proven effective into the basic insurance package. The evidence on the effectiveness and cost-effectiveness obtained during the period of the temporary conditional reimbursement program is used by the ZIN to determine whether the reimbursement for the medical technology under the basic insurance package can be continued. However, since 2019, the conditional reimbursement program was largely replaced by two other schemes, the “Subsidy scheme for promising care” and “Conditional reimbursement for orphan drugs”.

On April 20, 2021, the Dutch Healthcare Institute (ZIN) published an annual report on the progress of the conditional reimbursement program. The report provides an overview of the medical procedures and drugs under the conditional reimbursement program.

In 2020, there were 13 ongoing projects, six of which concerned medical technologies, including:

  1. Treatment of lumbosacral radicular syndrome in lumbar disc herniation with percutaneous transforaminal endoscopic discectomy;
  2. Breast reconstruction after breast cancer with autologous fat transplantation (included until October 1, 2022);
  3. Sacral neuromodulation for treatment-resistant, functional constipation with delayed intestinal passage (included until January 1, 2022);
  4. Combination of cytoreductive surgery and intraperitoneal hyperthermy chemotherapy in patients with both gastric carcinoma and synchronous peritoneal metastases or tumor-positive abdominal fluid (included until October 1, 2022);
  5. CardioMEMS pulmonary artery monitoring in patients with chronic heart failure New York Heart Association Class III with recurrent hospital admissions (included until April 1, 2023);
  6. Treatment with Binamed medical silver clothing or Dermacura antibacterial dressing for children and adults with moderate to severe atopic eczema (included until October 1, 2023).

One project was accomplished in 2020: percutaneous transforaminal endoscopic discectomy (PTED) in the treatment of lumbosacral radicular syndrome in lumbar disc herniation. Based on the obtained data, the ZIN concluded that PTED in the treatment of lumbosacral radicular syndrome in lumbar disc herniation conformed to the criteria of "science and practice". Therefore the treatment will be reimbursed under the basic insurance package. Currently, PTED is reimbursed only if the procedure is performed by surgeons who participated in the study. This transitional period applies until a tripartite agreement that defines the indications and training criteria will be published. The publication of the agreement is expected before July 1, 2021.

The full details in Dutch can be found here.

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