Health benefit package

In Sensible Care projects, the Dutch Healthcare Institute, together with other parties, is investigating the possibilities for improving care pathways for patients. As of early November 2020, there are 30 ongoing projects, including two projects for assessing knee and hip osteoarthritis treatment and medicines for castration-refractory prostate carcinoma at the final evaluation phase.

At the beginning of August 2019, the Dutch Healthcare Institute (Zorginstituut Nederland, ZIN) has published an Overview of the applications of healthcare products and activities for conditional entry into the Basic Insurance Package. Two applications for heated intraperitoneal chemotherapy in ovarian cancer and GAG therapy in bladder pain syndrome were considered.

At the beginning of June 2019, the National Healthcare Institute (Zorginstituut Nederland, ZIN) has published an Overview of the healthcare services, which were excluded or included with restrictions into Basic Insurance Package. Percutaneous liver perfusion with melphalan in patients with metastases from a uveal melanoma was included with restrictions, whereas CardioMEMS PA Monitoring was included in the context of research only.

At the beginning of February of 2019, the National Healthcare Institute (Zorginstituut Nederland, ZIN) has published an Overview of the healthcare activities which were excluded or included with restrictions into Basic Insurance Package.

Federal Department of Home Affairs (FDHA) released changes in coverage of medical procedures, IVD tests and medical aids in Switzerland. They include extension of coverage for neonatal screening to severe congenital immunodeficiencies, extension of coverage under restrictions for TAVI, gene test for breast cancer, PET, PET / CT, local superficial hyperthermia during tumour treatment, external defibrillator and coverage for sub-urethral tapes for the treatment of stress urinary incontinence in women. Also, changes in the coverage for neonatal screening were introduced.

At the end of September of 2018, the National Healthcare Institute (Zorginstituut Nederland, ZIN) has published an Overview of the healthcare activities, which were excluded or included with restrictions into Basic Insurance Package.

During the last meeting of the Interterritorial Council of the National Health System in Spain (end of April) three decisions about coverage or new services or indications in the National Benefit Catalogue were announced. They concern hearing aids, micropigmentation of the nipples and continuous glucose monitoring. The changes are still due to be formalized in a form of a Royal Decree.

At the end of April, 2018, the National Healthcare Institute (Zorginstituut Nederland, ZIN) has published an Overview of the healthcare activities, which were excluded or included with restrictions into Basic Insurance Package.

In March 2013, the National Association of Statutory Health Insurance Funds requested a benefit assessment of surgical lung volume reduction in severe pulmonary emphysema. The Joint Federal Committee (G-BA) decided on February 15th 2018 that the method will remain a benefit in the inpatient sector in Germany. The was supported by a health technology assessment provided by the Institute for Quality and Efficiency in Health Care (IQWiG).

The Dutch National Health Care Institute (Zorginstituut Nederland) published a position paper with results of 4-years observation of transluminal endoscopic step-up approach in patients with infected pancreatic necrosis. In accordance to this document the procedure fulfils the criteria ‘state of science and practice’. The method can be reimbursed within basic health insurance.

The Dutch National Health Care Institute considered that application of one-way endobronchial valves for endobronchial lung volume reduction fulfills the criteria of “state of science and practice” for patients with severe emphysema and insufficiency of drug treatment. Therefore, this procedure can be included into a basic package for appropriate indication.

Joint Federal Committee (G-BA) evaluated the use of diabetic foot syndrome with hyperbaric oxygen therapy (HBO) as a complementary treatment. Based on studies showing a faster healing process, the G-BA decided to include the method as a benefit in the outpatient sector and expand the indication for the method to a lower severity grade in the inpatient sector.