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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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Evolution of procurement of medical devices in Italy

12 Dec 2018

In late October 2018, Assobiomedica, the body that represents the companies that operate in the medical device sector, published the fourth edition of the document “Public policies for the purchase of medical devices.”

Italian healthcare system is highly regionalized. Even within the regions, there has not been quite a lot of cooperation traditionally. Thus, the medical device companies may have more leverage when negotiating with one entity, rather than with a group of entities. Many incentives have existed (or still exist) whose aim was to organize a well-functioning body, which would take care of procurement on the regional level. However, the success of these incentives varied among the Italian regions.

This document (“Public policies for the purchase of medical devices”) has been developed by the Tender Observatory, which is composed of Assobiomedica Study Center (CSA) and European Research Center (CER). They have stratified four (4) types of acquisitions:

  • Single acquisitions, made by separate healthcare facilities
  • Group acquisitions, made by groups of healthcare facilities, with specific characteristics for every group
  • Centralized regional acquisitions, made by the regional centers for procurement
  • Purchases made through Consip, a public company in charge of public procurement

Below are some of the interesting conclusions from the publication:

  • In 2007, 95% of the total amount awarded in the public tenders consisted of the single or group acquisitions, while the remainder consisted of centralized regional acquisitions. In 2017, this ratio was 35% and 65%, respectively. The percentage of purchases made through Consip are neglectable
  • There is a negative trend of the number of healthcare facilities participating in one tender; for example, in 2009, on average eight (8) entities engaged in the centralized regional acquisitions, while the average for 2017 is only three (3)
  • In 2007, 30% of the tenders were accomplished within one year, 40% within 18 months and for the last 30%, the process lasted more than 18 months. In 2017, 55% of the tenders were accomplished within less than 6 months
  • There is no rule which could explain the difference among the regions in the period 2007-2017. Campania region in the south of Italy leads, with more than 70% of the acquisitions being centralized regional acquisitions. On the other hand, less than 5% of the purchases in Sicily and Sardinia were centralized regional acquisitions. In Lombardy, the percentage of the centralized regional procurement is 35%, in Emilia Romagna 30% and in Veneto 40%, with the remaining percentage being the mix of single and group acquisitions.

See the full report in Italian here, which also contains the list of the regional procurement bodies.

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