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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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Mini-HTA for irreversible electroporation (IRE) for treatment of liver metastases was prepared by Oslo University Hospital

Irreversible electroporation (IRE) is a new minimally invasive method for the ablation of tumors. Unlike the current leading methods of thermal ablation, such as radiofrequency ablation and cryoablation, IRE based on non-thermal electric energy. There is currently one commercially available device for IRE - NanoKnife® System (AngioDynamics, USA).

Currently, this method is not used in Norway. Additionally, in Nordic countries, this treatment is offered in Uppsala, Sweden and at Rigshospitalet in Copenhagen, Denmark.

At the beginning of September, a report with results of mini-HTA of irreversible electroporation for treatment of liver metastases that was performed by Oslo University Hospital was published at the Norwegian national database.

The purpose of the assessment was to introduce a new method and evaluate this technology in relation to efficacy, safety, associated costs and ethics in patients who have inoperable primary and secondary malignant liver tumors (liver metastases (colorectal and others), hepatocellular carcinoma, cholangiocarcinoma) and not suitable for other ablation treatment. A systematic literature search for systematic literature reviews, clinical trials, clinical guidelines and health technology assessments was performed.

In accordance to the report, there are no RCTs, cohort and comparative studies for IRE. The evidence is limited to a single-center case series studies. However, available evidence was found suitable to confirm that method is safe and feasible. Additionally, it was stated that results from identified studies are transferable to clinical practice. The expected number of patients for IRE procedure is about 15 patients.

The conclusion of mini-HTA stated that IRE should be included as part of the routine clinical practice in the hospital. The method will be continuously monitored through the quality registry, and all data will be incorporated into IRE international registry.

See full report in Norwegian here.

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