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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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The Institute for the Hospital Remuneration System (InEK) published the German 2024 DRG catalog

05 Dec 2023

On November 14, 2023, the Institute for the Hospital Remuneration System (InEK) published the DRG catalog (Fallpauschalen-Katalog) with the list of DRGs and additional reimbursement categories (ZEs) for 2024.

The following changes were introduced:

  • Six new DRGs were introduced. The newly introduced DRGs belong mainly to the gastrointestinal, orthopedics, and pulmonary and airways fields;
  • Eighteen new ZE categories (for drugs and blood components products only, none for medical technologies) were added to the catalog. Also, for one technology, the ZE category changed from the one with the tariff determined on the regional level to the ZE category with a nationally determined tariff;
  • Annex 3a, which lists the DRGs with the tariffs determined on the regional level (for the cases requiring long-lasting hospitalization, e.g., severe burns or organ donation), was significantly extended – now it includes 35 more DRGs in comparison with 2023;
  • A new annex (3c) was introduced, providing the nursing care valuation ratios for the hybrid DRGs (n=12).

Also, the catalog for risk adjustment for nursing care (care burden catalog) for 2024 was published.

Moreover, the InEK published the list of the new diagnostic and treatment methods (NUB) with approved status (status 1), which were integrated into the DRG system for 2024 in the form of an add-on reimbursement (ZE) categories. The list contains seven positions of drugs, one blood components product, and no medical technologies. The list of the requests for NUB with the granted statuses for 2024 is expected to be available in January-February 2024.

The full details in German can be found here and here.

This news is just one of about 300 market access news collected by our team in the premium subscription service Market Access Monitor every week from more than 80 organizations. Access our paid service to stay on top of all developments specifically for your products in Europe (reimbursement news) and globally (HTA news). Access is organized as an online Database and email alert formats. Contact us to get a free, three-month, no-obligation trial.