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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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Med Tech-related technology assessments and clinical guidelines from NICE in September 2023

The National Institute for Health and Care Excellence (NICE) develops Interventional Procedures Guidance (IPG) for most novel interventional procedures entering the English market. The program focuses solely on clinical evidence. Recommendations may vary from "for research only" to "for use with standard arrangements for clinical governance, consent, and audit." Recommendations are not binding, although they are followed by providers and commissioners.

In September 2023, NICE published three new IPGs and made the following conclusions:

Health Technology Evaluations (HTE) are the new type of NICE guidance that uses the Early Value Assessment (EVA) approach to provide rapid conditional recommendations on promising health technologies that have the potential to address unmet national needs. NICE evaluates the available evidence to determine if earlier patient and system access in the NHS is appropriate while further evidence is generated.

In September 2023, NICE published three new HTEs and made the following recommendations: 

  • AI technologies to aid contouring for radiotherapy treatment planning can be used in the NHS in people having external beam radiotherapy while more evidence is generated. AI technologies must be used with healthcare professional review of contours. Nine technologies are recommended for use once they have Digital Technology Assessment Criteria (DTAC) approval: AI-Rad Companion Organs RT, ART-Plan, DLCExpert, INTContour, Limbus Contour, MIM Contour ProtégéAI, MRCAT Prostate plus Auto-contouring, MVision Segmentation Service, RayStation;
  • KardiaMobile 6L can be used in psychiatric services as an option to measure cardiac QT interval for adults having or about to have antipsychotic medication, while more evidence is generated only in certain clinical indications defined in the document;
  • Further research is needed for Artificial intelligence (AI)‑derived software to analyze chest X‑rays alongside clinician review for suspected lung cancer in adults referred from primary care. With the available evidence, it is not possible to assess the clinical and cost benefits or risks of using the technology in the NHS. So, AI-derived software should not be used for clinical decision-making in the NHS until more evidence is available. Centers using them should generate evidence that will allow clinical and cost benefits to be assessed in the future. NICE considered 14 technologies for the assessment;

Two new clinical guidelines were published in September 2023:

Four clinical guidelines were updated in September 2023:

See the full details here.

This news is just one of about 300 market access news collected by our team in the subscription services "HTA Alerts" and "Reimbursement Alerts" every two weeks from more than 80 organizations. Access our paid subscription services to stay on top of all developments specifically for your products in Europe (reimbursement news) and globally (HTA news). Contact us to get a free, three-month, no-obligation trial.