Germany benefit assessment

On February 17, 2025, the Clinical Coding and Schedule Development (CCSD) working group, which develops and maintains procedural and diagnostics nomenclatures for private payers in England, published Bulletins 200 and 096 with changes to be implemented no later than March 10, 2025. Thirty-five new procedure codes related to cardiovascular, gastrointestinal, nephrology, peripheral vascular, and general surgery areas and ten new diagnostic codes concerning in-vitro diagnostics, endoscopy, and pulmonology were introduced.

On January 28, 2022, the Institute for the Hospital Remuneration System (InEK) has published the list of the requests for innovation funding (NUB) that were submitted by the hospitals in 2021. The medical technologies belonging to the cardiovascular, ENT, eHealth, gastrointestinal, neuromodulation, neurovascular, orthopedic, and other technology groups obtained positive status 1.

At the beginning of July of 2018, the Institute for Quality and Efficiency in Health Care (IQWiG) has published a final report regarding the benefit assessment of allogeneic stem cell transplantation (ASCT) in aggressive B-cell non-Hodgkin's lymphoma (B-NHL) and in T-cell non-Hodgkin's lymphoma (T-NHL). IQWiG concluded that the benefit of ASCT in B-NHL and T-NHL is unclear for now, as no meaningful studies are available.

At the beginning of July of 2018, the Federal Joint Committee (G-BA) has commissioned to the Institute for Quality and Efficiency in Health Care (IQWiG) to provide an assessment of potential harm and benefits of biomarker-based tests for or against adjuvant chemotherapy in primary breast to understand its efficacy in comparison with the previous standard examinations in women who do not require chemotherapy due to a low/intermediate risk of relapse. The final report is expected to be released by G-BA at the end of 2018.

In April of 2018, the Institute for Quality and Efficiency in Health Care (IQWiG) has published an update for the report V14-03 “Systematic guideline search and appraisal, as well as extraction of relevant recommendations, for a disease management program (DMP) for osteoporosis” from 2016 in order to find additional evidence on integrated concepts of medical and physical rehabilitation. However, no new information was identified and included into the report.

On the 23rd of May of 2018, the Institute for Quality and Efficiency in Health Care (IQWiG) has published an update version of the report “Colorectal cancer screening in persons with familial risk”, which was commissioned to IQWiG by the Federal Joint Committee (G-BA) in October of 2017 to provide an answer, whether people under 55 years of age with a family history of colorectal cancer benefit from a screening test. Like the previous report, the current one therefore concluded that the benefit of screening for under 55-year-olds with a family history of colorectal cancer is unclear.

In May of 2018, the Federal Joint Committee (G-BA) approved two additional indications for application of PET/CT for management of malignant lymphomas for coverage within statutory health insurance. As the procedures were included into Directive for methods and examinations and Directive methods of the contract medical care, they are now reimbursed in both hospital and out-patient settings.