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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 G-BA Innovation Committee recommends transfer to standard care for another four completed projects in Germany

In mid-August 2024, the Innovation Committee at the Federal Joint Committee (G-BA) published the decisions recommending the transfer to standard care for another four completed projects. The projects were dedicated to the topics of support for families with a parent suffering from cancer, modeling routine risk screening in children, reducing problematic media use, promoting treatment motivation in people with computer game addiction and Internet addiction, and follow-up care for gestational diabetes.

In the “Family SCOUT – cross-sector and cross-phase support for families with a parent suffering from cancer” project, families were provided with a specially trained contact person who advised on needs-based care options and supported open discussions on coping with the disease. In addition, the so-called Family SCOUTS set up cross-professional care networks within the project region. The project demonstrated that the advice provided by a fixed contact person across providers, sectors, and disease phases is largely positively perceived by families. The project results are, therefore, being forwarded to the state health and social ministries, the National Association of Statutory Health Insurance Funds, the German Hospital Federation, the National Association of Statutory Health Insurance Physicians, as well as the Federal Association of Non-statutory Welfare. These organizations are requested to examine how the new form of care can be used for affected families.

The project “PROMPt – Primary indicative and optimized allocation to targeted interventions for emotional and behavioral problems in children” tested a model routine risk screening. The screening was used in regular health examinations for children - the so-called U-examinations. If necessary, the doctor then recommended specific further measures. Within the project, two prevention programs were used, and, if necessary, in-depth diagnostics were carried out by regional specialists. The project demonstrated that the use of routine risk screening was met with a high level of acceptance by both families and service providers and that existing prevention offers were used significantly more frequently. Despite the limitations of the project results, the results will be forwarded to the GKV-Spitzenverband, the Central Prevention Testing Office, and the Federal Conference for Educational Counseling. These organizations are requested to examine how the tested approaches and knowledge gained can be implemented to support a targeted recommendation of suitable prevention offers.

To be able to counteract Internet addiction disorder at an early stage, the “OMPRIS – Online-based motivational program to reduce problematic media use and promote treatment motivation in people with computer game addiction and Internet addiction” project developed and tested a four-week online intervention: those affected received online individual therapy sessions twice a week and up to three social counseling sessions in total. The project demonstrated that the online intervention effectively reduced problematic media use and can thus expand the treatment options for Internet addiction disorder. The results of the project will be forwarded to a number of recipients with a request to check whether these can be used as part of low-threshold counseling services for risky Internet use or as part of psychotherapeutic services.

Based on the evaluated data, the “GestDiNa_basic – follow-up care for gestational diabetes” project identified incentives and barriers to good aftercare in gestational diabetes and derived building blocks for a patient-centered care model. These results will be forwarded to the Association of Scientific Medical Societies with a request to examine the extent to which the results of this project can be considered in the further development of corresponding S3 clinical guidelines.

The full details in German can be found here, here (Family SCOUT project), here (PROMPt project), here (OMPRIS project), and here (GestDiNa_basic project).

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.