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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 National Health Care Institute has concluded that MammaPrint® is not eligible for reimbursement from the basic package

The MammaPrint® is a genomic test used to analyze the activity of certain genes in early-stage breast cancer for prediction of the risk recurrence and metastasis. It was introduced more than 10 years ago with the aim to decide whether chemotherapy is needed or not. The assumption is that there is a group of patients where the benefits of chemotherapy may not outweigh the side effects of this therapy.

In 2010, CVZ, the predecessor of the Dutch Healthcare Institute, expressed a negative view on the MammaPrint®. According to the CVZ assessment, the evidence for clinical benefits of the test was lacking.

The Dutch National Health Care Institute has re-assessed whether the MammaPrint® should be included in the basic insurance package according to the results of the international MINDACT study. The Dutch National Health Care Institute looked at the difference in 5-year survival without metastases as a predictor for overall survival after 10 years. The omission of chemotherapy based on the MammaPrint® may lead to an increase in metastases and thus mortality. As a result, this test is not eligible for reimbursement from the basic insurance package.

See full details here.

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