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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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Indications for autologous fat transplantation (lipofilling) can be expanded in the Dutch basic health insurance package

18 Jul 2017

Autologous fat transplantation, or augmentation, is a surgical technique when fat cells are harvested by liposuction and then injected into areas of the same person where a defect of soft tissue.

The conclusion of the Dutch Health Care Institute (Zorginstituut Nederland) is that AFT is effective method, and it can be a part of the basic health insurance package for the following indications:

  • Partial defects of the head and neck as a result of the following rare hereditary disorders: Parry-Romberg Syndrome, local (linear) scleroderma, craniofacial microsomia and Treacher Collins syndrome;
  • Partial defects in head and neck area in case of the following non-congenital disorders: enucleation (as part of the orbital reconstruction after eye removal and decrease of face tissue due to paralysis);
  • HIV-associated lipoatrophy (fat loss in buttocks and on face as a side effect of a number of 'old' HIV-inhibitors);
  • Fibrosis (scarring) resulting from trauma, burns, surgery or radiotherapy. 

Application of autologous fat transplantation for breast reconstruction was reviewed by Zorginstituut Nederland in 2016.

AFT will be reimbursed only for these indications as well as under compliance with the conditions for plastic surgery treatment. It means that application of this method to enhance the appearance, or for cosmetic purpose, is excluded from the insurance package.

The Dutch Health Care Institute has come to the decision that AFT is not effective and therefore cannot be a part of the basic health insurance package for the following conditions:

  • Dupuytren's disease (connective tissue surfacing),
  • Raynaud's phenomenon (out of fingers discolorations),
  • Congenital hand abnormalities,
  • Carpal tunnel syndrome (compression of the median nerve in the hand or the wrist) and osteoarthritis (a form of arthrosis),
  • Chronic wounds and ulcers (external inflammation of the skin).

Read full story in Dutch here.

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