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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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MTRC provides support with procedure volume analysis using administrative databases

03 Dec 2020

Procedure volume information is crucial to develop an understanding of the market size, frequency of use of alternative / competitor procedures, specifics of the procedure in scope (e.g., length of stay, allocation to DRGs, age of treated patients).

There are two sources of market size information:

  • Marketing reports, based on interviews of sample hospitals with extrapolation to the whole country
  • Analysis, using administrative databases

Marketing reports have a serious limitation due to the need to extrapolate data from the small subset of hospitals to the entire country, which can be a biased approach. On the other hand, marketing reports could be very valuable when a procedure or device is scope is not yet recognized by the health care system, and there is no other way to understand the frequency of use for it.

Analysis using administrative databases is another common approach to understand the number of performed procedures / market size for a procedure. In this exercise, our team identifies relevant procedure codes from national coding systems (e.g., OPS in Germany) and collects procedure volume and other supportive information from national databases in each country. 

MTRC provides procedure volume analysis using national administrative databases in Austria, Belgium, England, Finland, France, Germany, the Netherlands, Norway, Sweden and Switzerland. 

Learn more here