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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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New companion diagnostic tests will be reimbursed via the German Uniform Evaluation Standard (EBM)

On August 11, 2022, the National Association of Statutory Health Insurance Physicians (KBV) announced that two new services in the in-vitro diagnostics field in lung and colon cancer, respectively, will be reimbursed via the German Uniform Evaluation Standard (EBM).

For this purpose, the following new codes for companion diagnostic tests will be included in the EBM catalog:

  • 19465 “Detection or exclusion of all known MET exon 14 skipping mutations using circulating tumor DNA to indicate targeted treatment of adult patients with advanced non-small cell lung cancer when mandatory according to the prescribing information” with a tariff of €443.21;
  • 32868 “Genotyping to determine UDP-glucuronosyltransferase 1A1 (UGT1A1) metabolization status before systemic therapy with an irinotecan-containing medicinal product” with a tariff of €50.

These changes will be introduced in the EBM catalog on October 1, 2022. The corresponding decisions were made by the Evaluation Committee (Bewertungsausschuss) on August 5, 2022.

The full details in German can be found here and here. The Evaluation Committee decisions can be found here and here.

This news is just one of about 300 market access news collected by our team in the subscription services "HTA Alerts" and "Reimbursement Alerts" every two weeks from more than 80 organizations. Access our paid subscription services to stay on top of all developments specifically for your products in Europe (reimbursement news) and globally (HTA news).

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