Implantable cardioverter defibrillator (ICD)

The French National Authority for Health (HAS) released new recommendations about add-on reimbursement of medical devices and medical aids from the meetings of the National Commission for Evaluation of Medical Devices and Health Technologies (CNEDiMTS) in August 2023. Eight recommendations were published in relation to the registration, modification of registration conditions, and renewal of registration for devices in the List of reimbursable products and services (LPPR). Opinions concern cardiovascular, peripheral vascular and neurovascular devices, as well as medical aids.

The French National Authority for Health (HAS) released new recommendations about add-on reimbursement of medical devices and medical aids from the meetings of the National Commission for Evaluation of Medical Devices and Health Technologies (CNEDiMTS) in February 2023. Twenty-eight recommendations were published in relation to the registration, modification of registration conditions, and renewal of registration for devices in the List of reimbursable products and services (LPPR). Opinions concern cardiovascular and peripheral vascular, neurovascular, ophthalmological, spine, and orthopedic devices, surgical procedures, as well as medical aids.

On July 15, 2022, the Austrian Institute for HTA (AIHTA) published five decision support documents, which provide recommendations regarding the inclusion of new medical interventions in the catalog of individual medical services of the performance-oriented hospital financing (Leistungsorientierten Krankenanstaltenfinanzierung, LKF) model, as well as four updates to previous decision support documents. The decisions relate mainly to cardiovascular and gastrointestinal technology groups.

On March 31, 2022, NHS Digital released HRG4+ Local Payment Grouper for 2022/23 for use from April 01, 2022. In general, there are significant changes in base HRG design. A total of 120 new HRGs were created, and multiple HRGs were removed, so the total number increased by 62 from 2,838 to 2,900.

On March 17, 2022, the French National Authority for Health (HAS) published a standard for telemonitoring of patients with implantable cardiac devices (implantable defibrillators and pacemakers). In January 2022, the HAS also published standards for medical telemonitoring of four chronic pathologies (chronic respiratory failure, chronic heart failure, chronic renal failure, and diabetes). All these standards must be met by technologies in order to be reimbursed by the new reimbursement framework for telemonitoring, which is expected to enter into force in July 2022.

On November 9, 2021, the Belgian Health Care Knowledge Center (KCE) published the health technology assessment report "Remote monitoring of patients with cardiovascular implantable electronic devices (CIED)". Analysis of efficacy and safety of remote monitoring showed an advantage in various aspects. Cost-effectiveness analysis indicates that remote cardiac monitoring of ICDs and PMs is cost-effective compared to monitoring based on in-clinic visits.

In late September 2021, the Austrian version of the DRG system (LKF) 2022 model with the relevant supplementary documents was published in Austria. The document "Changes and innovations in the 2022 LKF model" (Änderungen und Neuerungen in den LKF-Modellen 2022) summarizes the most significant changes and innovations in the LKF model for inpatient and outpatient care. The newly added procedure codes concern mainly the cardiovascular, E-Health, and gastrointestinal area.

In mid-June 2021, the document "Changes and innovations in the 2022 LKF model" (Änderungen und Neuerungen in den LKF-Modellen 2022) was published. The document summarizes the most significant changes and innovations in the LKF model for inpatient and outpatient care. The newly added procedure codes concern mainly the cardiovascular, e-Health, and gastrointestinal area.

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.

The National disease management guideline for chronic heart failure with recommendations for diagnostics and therapy has been revised. It is now available free of charge on the internet pages of the Medical Center for Quality in Medicine.

The report presents a summary of reimbursement situation for implantable cardioverter defibrillators. Both Implantable Cardioverter Defibrillators (ICDs) and Cardiac Resynchronization Therapy Defibrillator (CRT-D) are considered. Use of ICD is considered for ventricular tachycardia and ventricular fibrillation. The analysis covers procedure coding, payment mechanism, reimbursement tariffs and policy restrictions in 11 EU countries including Austria, Belgium, Denmark, England, France, Germany, Italy, the Netherlands, Norway, Sweden and Switzerland.

On 20th of July, 2018, the Austrian HTA body, the Ludwig-Boltzmann Institute (LBI) released an assessment of the subcutaneous implantable cardioverter defibrillator to determine coverage of the service. Authors concluded that evidence is insufficient to make conclusions about the comparative effectiveness of subcutaneous and transvenous ICDs. However, a substantially lower risk for lead complications in patients treated with subcutaneous ICD.