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Evidence gap analysis

Strategic analysis of the sufficiency of evidence to obtain reimbursement and HTA approval in Europe and recommendations about evidence generation

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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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Five-year implementation strategy for Hybrid closed loop technologies in England

On January 22, 2024, NHS England published a 5-year implementation strategy for Hybrid closed loop (HCL) technologies following the publication of the NICE technology appraisal (TA943). Normally, commissioners and providers are expected to implement NICE TA recommendations within three months. NICE agreed to extend the standard period to 5 years to allow the NHS time to train and build specialist competencies within the clinical workforce and procure HCL technologies at cost-effective prices.

The implementation strategy is primarily aimed at integrated care boards (ICB) leads, trust clinical leads, regional diabetes leads, and clinical network leads. Key elements of the implementation strategy include workforce capacity and competencies, patient and professional education, commercial requirements, resources to support mobilization, ICB reimbursements for HCL technologies, as well as activity and outcomes reporting.

ICBs are responsible for the implementation of HCL and ensuring equitable access for their local population.

NHS England will contribute to the costs of HCL and offer reimbursement funding:

  • From 2024/25, NHS England will make available capped funding to all ICBs, from which they can request reimbursement for 75% of the estimated incremental costs of HCL (the cost of the technology and operational delivery of the service);
  • Each ICB’s maximum funding will be calculated using data from the National Diabetes Audit and National Paediatric Diabetes Audit on the total eligible population. NHS England will review HCL activity and make retrospective quarterly reimbursements to ICBs as Service Development Funding. Where ICBs are not claiming the maximum amount in a year, NHS England may, by exception and with the agreement of regional teams, reallocate underspend to other ICBs;

ICBs must meet specific criteria to receive HCL reimbursement (e.g., technologies must be purchased from the national framework of HCL technologies hosted by NHS Supply Chain once the framework is established in the 2024/25 financial year).

NHS England also released a £2.5 million HCL mobilization fund in December 2023 (£60,000 per ICB) to support activities defined in the implementation strategy.

See the full details here.

This news is just one of about 300 market access news collected by our team in the premium subscription service Market Access Monitor every week from more than 80 organizations. Access our paid service to stay on top of all developments specifically for your products in Europe (reimbursement news) and globally (HTA news). Access is organized as an online Database and email alert formats. Contact us to get a free, three-month, no-obligation trial.