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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 Fund is extended until March 2021

29 Apr 2019

The Innovation Fund in Germany was created in 2015 for the period from 2016 to 2019, with the primary aim to improve health care for policyholders and patients in statutory health insurance (SHI). The Innovation Committee set up at the Joint Federal Committee (G-BA) had the task of promoting innovative, in particular cross-sectoral, forms of care that exceed the current standard of care with a budget up to €225 million a year. In addition, the Innovation Committee promoted patient-oriented health services research with a budget of up to €75 million a year, which aims to gain insight into the improvement of existing health care provision.

Since 2016, the Innovation Committee has published a total of 22 funding announcements in four funding waves. As expected, the interest of the actors in the German health care system was huge, so that in each funding wave far more project applications were submitted than could have been financed from the available funding budgets. Following a rigorous evaluation of all project applications in line with the eligibility criteria defined in the funding announcements, 119 projects in the field of "New forms of care" and 171 projects in the field of "Healthcare research" were selected for funding. While the projects selected for funding in 2016 and 2017 are already well advanced, the most recently chosen projects are still in the start-up phase.

The Innovation Fund has provided essential impulses for the initiation of innovative care approaches. However, there are currently no results reports of the project participants or evaluation reports of the institutes commissioned with the scientific monitoring, so that there are no reliable findings on the effects of the Innovation Fund on the supply of SHI.

Nevertheless, in the third week of March 2019, the governing parties have agreed in the coalition agreement that the innovation funding should be continued beyond 2019 (initially for two years, until March 2021) with an annual budget of €200 million. The continuation of the functioning of the Innovation Fund requires adapting of the Fund's design rules and funding processes.

The full details in German can be found here.

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