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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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MedTech-related technology assessments and clinical guidelines from NICE in May 2022

IPG is developed for most of the 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 May 2022, NICE published three new Interventional Procedures Guidance (IPG) and provided the following conclusions:

  • For people with unfavorable aneurysm morphology needing an EVAR as a primary procedure, or for people with an existing EVAR who need a secondary procedure, evidence on the safety of using endoanchoring systems is adequate, but evidence on efficacy is limited in quantity and quality. Therefore, it should only be used with special arrangements for clinical governance, consent, and audit or research;
  • For people with favorable aneurysm morphology needing an EVAR as a primary procedure, evidence on the safety of using endoanchoring systems is adequate. However, evidence on efficacy is inadequate in quantity and quality. Therefore, for these people, this procedure should only be used in the context of research.

Medical Technologies Guidance (MTG) evaluates new, innovative medical devices and diagnostics. It looks at medical technologies that deliver treatment, like those implanted during surgical procedures, give greater independence to patients, or detect or monitor medical conditions.

In May 2022, NICE issued one new MTGs on Sleepio to treat insomnia and insomnia symptoms, which provided the following recommendations:

  • Sleepio is recommended as a cost-saving option for treating insomnia and insomnia symptoms in primary care for people who would otherwise be offered sleep hygiene or sleeping pills;
  • For people who may be at higher risk of other sleep disorder conditions, such as in pregnancy or in people with comorbidities, a medical assessment should be done before referral to Sleepio;
  • More research or data collection is recommended on Sleepio for people who are eligible for face-to-face cognitive behavioral therapy for insomnia (CBT‑I) in primary care. This is because there is limited clinical evidence to show how effective Sleepio is compared with face-to-face CBT‑I.

The MedTech Innovation Briefings (MIBs) is the advice program of NICE for innovative technologies. It provides an overview of clinical effectiveness, safety, and cost. It does not offer formal guidance, and it, therefore, does not provide any recommendations. The six new MIBs published in May 2022 are:

See the full details here

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