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Cost-effective reimbursement analysis for medical technologies in Europe

Procedure coding, payment mechanism, reimbursement tariffs, policy, and HTA considerations in 34 EU countries

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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 released a White Paper with a summary of clinical evidence requirements for LPPR List process for implants and invasive devices in France (analysis of negative recommendations)

In France, reimbursements for hospital procedures are made solely via a DRG system, which is called “Groupe Homogène de Maladies” (GHM). All hospitalizations, as well as day case procedures and ambulatory treatments, are reimbursed via DRG.

However, there is a possibility of add-on reimbursement (on top of the DRG tariff) via LPPR List. Add-on reimbursement is possible for selected implantable (Title III) or invasive non-implantable (Title V) devices. 

Clinical assessment is performed by the National Committee for the Evaluation of Medical Devices and Health Technologies (CNEDiMTS), and price negotiation is performed by the Economic Committee on Healthcare Products (CEPS).

MTRC released a White Paper with a summary of clinical evidence requirements for the LPPR List process for implants and invasive devices in France. In this White Paper, we identified evidence requirement pitfalls that act as a barrier to listing in the LPPR based on analyzing five recent HAS reports with negative recommendations from different medical disciplines. The analysis was performed in January 2024.

Read more and request a White Paper here.