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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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Evaluation of the organizational impact of mechanical thrombectomy in France

In France, the annual incidence of stroke is about 100,000 - 145,000 cases per year. French National Authority for Health (HAS) issued key national clinical guidance for management of stroke in 2009, followed by the action plan in relation to the topic for 2010-2014.

In 2016, French National Authority for Health (HAS) published health technology assessment of mechanical thrombectomy in stoke. It specified in the recommendations that mechanical thrombectomy "is of interest in the management of patients with acute ischemic stroke, in relation to an occlusion of a large calibre intracranial artery of the anterior circulation, visible in imaging within a period of 6 hours after the onset of symptoms, either initially in combination with intravenous thrombolysis (IVT), or as recourse technique: after failure of treatment with IVT, or alone in case of contraindication to IVT".

Report estimated annual usage of mechanical thrombectomy between 7000 and 10000 cases. 

To study current organizational modalities for provision of mechanical thrombectomy and to determine the most adequate way of further introduction of the method into French health care system, French National Authority for Health (HAS) has initiated an assessment of organizational impact of mechanical thrombectomy on the system of stroke management in France. 

The objective of this evaluation report was to analyze the impact of the introduction of mechanical thrombectomy in the strategy of early management of the stroke and to describe the implementation of an organizational system that includes:

  • Triaging of patients with stroke in care facilities
  • Defining multidisciplinary coordination
  • Setting the conditions for the management of the thrombectomy of the intracranial arteries by the endovascular route in the treatment of acute ischemic stroke

Report is planned for release in December 2017.

Further information is available at the HAS' web-site