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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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Extracorporeal shockwave therapy (ESWT) will be approved for use in out-patient settings in Germany

07 May 2018

On the 19th of April of 2018, the Federal Joint Committee (G-BA) was able to reassess previously excluded use of extracorporeal shockwave therapy (ESWT) in the indication of heel pain in plantar fasciitis on a current scientific basis and decided that ESWT will be used in out-patient settings in the future.

The first benefit assessment of the ESWT for orthopedic, surgical and pain therapeutic indications was provided by a predecessor body of the G-BA - the Federal Committee of Physicians and Health Insurance Funds, which concluded about insufficient evidence regarding the effectiveness and medical need. By the order of 24 April 1998, ESWT was classified as a non-prescriptible contractual medical treatment.

Then, in February of 2015, the G-BA has released the National Association of Statutory Health Insurance Funds’s (GKV-Spitzenverband’s) application for the assessment of ESWT procedure in heel pain with a resolution of 19 February 2015.

The final report “Extracorporeal shockwave therapy (ESWT) in heel pain” was published by the Institute for Quality and Efficiency in Health Care (IQWiG), which is responsible for the study research and evaluation in May of 2017. 

In the future, ESWT may be used at the expense of statutory health insurance in patients with limited physical activity due to the heel pain for at least six months after the several unsuccessful attempts to apply the different treatment methods such as conservative therapeutic approaches, stretching exercises and use of the shoe inserts. The use of ESWT as an additional measure can help to prevent future surgical interventions.

See full details online and in pdf version in German here.

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