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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 starts providing a service of reimbursement analysis in Australia

Australia is a complex country from a market access perspective. The main aspects of the healthcare system are centralized, with minor differences among states and territories.

Hospitals are financed by both the states/territories and the Australian Government, and they receive budgets adjusted for DRG and outpatient activities. Physician activities are reimbursed separately according to the Medicare Benefits Schedule. HTA framework is incorporated in the process of inclusion of new services in the Medicare Benefits Schedule.

MTRC uses the following sources for reimbursement analysis:

  • International Statistical Classification of Diseases and Related Health Problems, Tenth Revision, Australian Modification (ICD-10-AM), Twelfth Edition;
  • Australian Classification of Health Interventions (ACHI), Twelfth Edition;
  • Australian Coding Standards (ACS), Twelfth Edition;
  • AR-DRG Version 11.0;
  • Australian National Subacute and Non-Acute Patient Classification (AN-SNAP) Version 5.0;
  • Tier 2 Non-Admitted Services Classification Version 8.0;
  • Medicare Benefits Schedule (MBS)
  • Prostheses List (PL) of medical devices (for privately insured patients)

MTRC uses the following sources for policy analysis:

  • Evaluations and opinions of the Medical Services Advisory Committee (MSAC)

Contact us to discuss your needs with reimbursement analysis in Australia.