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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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The first MedTech Funding Mandate policy published in England

On January 26, 2021, NHS Accelerated Access Collaborative published the MedTech Funding Mandate policy for 2021/22, which will come into force in April 2021. According to the NHS Long Term Plan, introducing a MedTech Funding Mandate will support getting innovative medical devices, diagnostics, and digital products to patients faster.

Only technologies previously supported by the Innovation Technology Payment (ITP) will be included for the first year. To date, NHS England and NHS Improvement have funded the cost of procuring products on the ITP programs by directly reimbursing the supplier. The MedTech Funding Mandate does not directly fund the technologies included in the policy, and they will be reimbursed locally by Clinical Commissioning Groups (CCG).

MedTech Funding Mandate technologies are listed in the National Tariff Payment System (NTPS) Annex A (Innovative products list 13c). Technologies in the MedTech Funding Mandate can be procured through the relevant NHS Supply Chain framework from April 01, 2021.

MedTech Funding Mandate supports devices, diagnostics, or digital products that:

  • Are effective (demonstrated through positive NICE guidance);
  • Deliver material savings to the NHS (the benefits of the innovation are over £1 million over five years for the population of England);
  • Are cost-saving in-year (NICE modeling demonstrates a net saving in the first 12 months of implementing the technology);
  • Are affordable to the NHS (the budget impact should not exceed £20 million in any of the first three years).

The technologies that the policy will support in 2021/22 are:

  • Placental growth factor (PIGF) based testing – a blood test to rule out pre-eclampsia in pregnant women;
  • SecurAcath – for securing percutaneous catheters;
  • HeartFlow FFRCT– to create a 3D model of a patient's coronary arteries and assess the extent and location of blockages, estimating fractional flow reserve from coronary CT angiography;
  • gammaCore - a non-invasive vagus nerve stimulation therapy for treating cluster migraine.

Together with technology suppliers, NHS will work with patients and the Academic Health Science Networks (AHSNs) to support NHS organizations in implementing these innovations, understanding local and regional issues, and sharing learning from NHS organizations who have already implemented the innovations.

See the full details here.

This news is just one of about 300 market access news collected by our team in the subscription services "HTA Alerts" and "Reimbursement Alerts" every two weeks from more than 80 organizations. Access our paid subscription services to stay on top of all developments specifically for your products in Europe (reimbursement news) and globally (HTA news). First EU issues of both newsletters are available for download free-of-charge.

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