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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 two projects in Germany

On June 24, 2022, the Innovation Committee at the Federal Joint Committee (G-BA) published the decisions, recommending the transfer to standard care for two completed projects. The projects relate to preventing delirium, postoperative cognitive dysfunction, and back pain therapy using e-health.

A short overview of the projects is provided below:

  • "PAWEL – Patient safety, cost-effectiveness, and quality of life - reduction of the risk of delirium and postoperative cognitive dysfunction (POCD) after elective surgery in elderly" project offered a diverse approach consisting of a training concept for those treating people in medical practices and hospitals, orientation aids for patients as well as preventive measures and care management for postoperative delirium. With this approach, the incidence rate could be reduced directly after a planned operation, and the decline in mental functions reduced in the medium term;
  • Within the project "Rise-uP – Innovative back pain therapy using e-health for our patients" patients with non-specific back pain received immediate care from general practitioners and specialists based on the previously determined individual risk of the pain becoming chronic. Also, a specific health app was offered that included disease information and exercise instructions to improve both mental and physical health. As a result, the back pain in patients in the project group had decreased significantly more after 12 months than in the control group.

Innovation Fund is a vital instrument to propose and test a novel model of care (including the ones in the form of selective contracts). If the model proves valuable, it can be a subject for further dissemination in the country.

The detailed results of the projects are now being forwarded to the relevant organizations and institutions in the healthcare sector. In this regard, the respective stakeholders are requested to review the results and to consider them within their area of responsibility as far as possible.

The full details in German can be found here, here (decision for PAWEL project), and here (decision for Rise-uP project).

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