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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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Joint Federal Committee (G-BA) follows recommendations by the Institute for Quality and Efficiency in Health Care (IQWiG) in 70% of cases

The Institute for Quality and Efficiency in Health Care (IQWiG) in Germany is an independent scientific institute founded in 2004 that examines the benefits and harms of examination and treatment methods for patients. Based on the available scientific evidence, IQWiG provides information in the form of reports for following areas:

  • Drugs
  • Medical devices
  • Surgical procedures
  • Method of diagnosis and early detection
  • Treatment guidelines for physicians
  • Disease Management Programs (DMP)

By law, IQWiG can only be commissioned by the Joint Federal Committee (G-BA) and the Ministry of Health. Based on the reports, the G-BA decides about the inclusion of medical interventions as benefits in the statutory health insurance (SHI) in Germany.

Health technology assessments (HTA) for medical devices are only required in case of high-risk or invasiveness of the products. The focus of IQWiG’s work lies on drug assessments. At the turn of the year, IQWiG published its 220th benefit assessment. In 70% of the cases, the G-BA followed IQWiG’s recommendation or came to the same conclusion. In the remaining 30% of cases, G-BA’s judgement was equally often more positive as more negative than that of IQWiG.

All dossier evaluations in relation to medical devices are available in IQWiG’s repository.

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