Innovative payment schemes

On March 22, 2021, the repository of innovative laboratory tests (RIHN) and the Supplementary list were published. No new codes for IVD tests have been introduced and no codes were removed in the new versions of catalogs.

In the DRG system for 2021 (RZ21), the Dutch Healthcare Authority extended the ability to create innovative payment models via the "optional service" for the add-on reimbursement of some activities or devices that are not adequately covered existing DRG reimbursement.

The French Ministry of Solidarity and Health constantly announces the new experiments initiated under Article 51 of the Social Security Financing Act. These experiments are focused on various topics concerning medical technologies and organization of care. Eleven new experiments were initiated in the fourth quarter of 2020. The experiments concern areas of diabetes, nutrition, home monitoring of patients on oral cancer drugs, bariatric surgery, and others. More details about each of the experiments initiated in the fourth quarter of 2020 is provided in this article.

On December 18, 2020, the Dutch Healthcare Institute (ZIN) published the detailed application form for the Subsidy Scheme for Promising Care with explanatory notes. The closing date for submitting grant applications is March 2, 2021.

In November 2020, NHS Accelerated Access Collaborative published their plans for further introducing MedTech Funding Mandate after the COVID-19 outbreak. The MedTech Funding Mandate policy and the consultation outcome report are planning to be published this winter to support its launch in April 2021.

In November 2020, NHS Accelerated Access Collaborative updated the Rapid Uptake Products program for 2020/21. Three innovations from the 2019/20 program will continue through 2020/21, and four new products were added.

In November 2020, the Innovation and Technology Payment (ITP) program for 2020/21 was released by NHS Accelerated Access Collaborative. ITP 2020/21 builds on the Innovation and Technology Tariff (ITT) and ITP 2019/20; eight products will continue to be supported. Additionally, two digital technologies received continued support through the Evidence Generation Fund.

On October 16, 2020, the Order of the Ministry of Solidarity and Health in relation to the new experiment on reinforced support for the elderly people (DRAD) was published in the Official Journal of the French Republic. The experiment offers a solution to elderly people with loss of autonomy who wish to stay at home, for whom "classic" support from home services is not more sufficient.

The Belgian Health Care Knowledge Center (KCE) is conducting research towards a faster, substantiated decision on the reimbursement of innovative medical products. The project started in 2019 and is still being conducted.

On October 11, 2020, the French Ministry of Solidarity and Health published an Order in the French Official Journal relating to the coverage of CARMAT TAH by innovation package for the period of 48 months from the date of the beginning of the trial.

At the beginning of August 2020, the French National Authority for Health (HAS) issued a favorable opinion on the inclusion of the genome detection of SARS-CoV-2 by gene amplification on saliva samples to the innovation package (forfait innovation) according to the article L. 165-1-1 of the social security code. The package is approved by the Ministry of Solidarity and Health, after consultation with HAS.

The procedure for applying the ‘subsidy scheme for promising care’ is opened again. The period for applying has started on July 22 and will last till September 22, 2020.