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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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Glioblastoma therapy with tumor-treating fields will be available in Germany

Patients with a newly diagnosed glioblastoma will have an opportunity to benefit from the therapy with tumor-treating fields (TTF) at the expense of statutory health insurance. The Federal Joint Committee (G-BA) decided on March 20, 2020, the details concerning the indications and the quality assurance measures that will apply when prescribing this outpatient treatment method.

Glioblastoma is known as the most aggressive brain tumor. The cause of most cases of glioblastoma is not known. The typical duration of survival following diagnosis is 12 to 15 months, with fewer than 3 to 7% of people surviving longer than five years.

TTF treatment is a new method of inhibiting tumor growth based on electrostimulation. Electrical alternating current (AC) fields are locally transmitted to the tumor cells via the scalp; the electricity is generated in a small portable generator. The benefit assessment procedure found that those affected live an average of almost five months longer if TTF is also used in addition to standard therapy.

TTF treatment will be available for patients with a newly diagnosed glioblastoma if, after the complete possible surgery or after completion of chemoradiation, no early disease progression is detected. The TTF treatment is then used in the maintenance phase in addition to the further standard therapy, which includes adjuvant chemotherapy or after the first relapse occurs, relapse therapy. TTF treatment can be used until the second relapse.

The G-BA stipulated that the indication given by the prescribing specialist must be based on the recommendation of an interdisciplinary tumor consultation. As part of the regular follow-up, the use and tolerability of the TTF should be discussed as well.

Since the treatment with TTF takes place continuously at home, the patient and, if necessary, other auxiliary persons must be trained in the correct use of the device. In order to achieve the best possible therapy result, patients should use the TTF at least 18 hours a day.

The decision will be submitted to the Federal Ministry of Health for legal review and will enter into force after non-objection and publication in the Federal Gazette. Treatment with TTF can be provided as an outpatient service after the Evaluation Committee’s decision on the amount of reimbursement via the EBM (German Uniform Evaluation Standard).

The full details in German can be found here.

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