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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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Following a national ‘pause’ in the use of surgical mesh/tape to treat stress urinary incontinence and for urogynaecological prolapse a Mesh Pause Clinical Advisory Group (CAG) has been established

03 Sep 2018

On 10th July 2018, the Secretary of State for Health and Social Care and the Chief Medical Officer announced a ‘pause’ in the use of synthetic mesh/tape to treat stress urinary incontinence (SUI) and urogynaecological prolapse where the mesh is inserted through the vaginal wall. This ‘pause’ will be operationalised as a ‘RESTRICTION OF USE’, and a ‘HIGH VIGILANCE RESTRICTION PERIOD’ for any exceptions to this restriction and for a wider group of related procedures.

A Clinical Advisory Group has been established, representing NHS England Medical Directors and Specialised Commissioning CRG, BSUG (British Society of Urogynaecologists), BAUS (British Association of Urological Surgeons), ACPGBI (Association of Coloproctology of Great Britain and Ireland), The Pelvic Floor Society (TPFS) and the Royal College of Obstetrics and Gynaecology (RCOG), who provided recommendations to CMO with the following scope:

  1. Recommend the mesh/tape procedures to be included in the restriction of use
  2. Recommend and justify any mesh/tape procedures that should be excluded from the restriction, with or without increased vigilance
  3. Recommend any alternative non-mesh procedures that should be subject to increased vigilance, given the change in practice caused by the restriction on mesh/tape use
  4. Advise on high vigilance processes which must be followed by NHS and private hospitals for any mesh/tape surgery defined in (A) but deemed clinically essential during the restriction, and for the procedures defined in (B) and (C)
  5. Recommend how Trusts and GPs should support patients with advice, including patients newly referred or diagnosed, patients on the waiting list, and patients who have had previous mesh surgery who may have concerns

The attached document describes the actions to be taken. See full details here.

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