New coverage decisions in Switzerland

29

Jun 2020

On June 23, 2020, the Swiss Federal Office of Public Health (FOPH) announced several changes in the coverage of benefits that will take place soon.

Since July 2013, transcatheter aortic valve implantation (TAVI) was covered for people with high operative and non-operable risks. Recently, the application was made to expand the indication for TAVI to people with medium or low operating risk. Therefore, it will be covered in the case of medium operative risk since July 1, 2020, while it will not be covered for the patients with low operative risk.

The FOPH announced that more changes in the KLV list are expected until the end of the year (July 1, 2020; October 1, 2020; January 1, 2021).

Regarding the adjustments in the List of Aids (EMAp/MiGeL), the splints for moving after operations or illnesses - excluding the splints for shoulder mobilization - will no longer be reimbursed. Furthermore, the maximum reimbursable amounts for nCPAP devices for sleep apnea care and devices for mechanical ventilation at home have been adjusted following the increase in prices in Switzerland and the comparisons with prices charged abroad. A new reimbursement method with annual lump sums has been applied to auxiliary means for tracheostomy (artificial ventilation). These changes will enter into force on January 1, 2021. But, some changes will enter into force on July 1, 2020, as mentioned earlier.

The List of Analyses (AL/EA) has been reworked and adapted to the current state of science and technology. Obsolete and repeatedly priced positions have been written off. In the future, the AL/EA will also contain comprehensive information on the invoicing by laboratories as well as on the checking of invoices by policyholders. The revised AL/EA will enter into force on January 1, 2021. One minor change will also be introduced starting from July 1, 2020.

See more details in Italian (switch to German or French in the top-right corner) here.

Subscribe to our newsletter delivered every second week not to miss important reimbursement information.

Related news

27

Nov 2020

On October 30, 2020, the Swiss Federal Statistics Office (UFS) published the 2021 version of the procedure code (CHOP) nomenclature in French and Italian. The version in the German language was published in July 2020. The most important changes regard cardiovascular and peripheral vascular interventions.

Read more

19

Nov 2020

The Government of the Russian Federation approved the Order of November 7, 2020, N 2892-r on budget allocations of over 800 million rubles for the provision of subsidies to subordinate institutions of Rospotrebnadzor (Federal Service for Surveillance on Consumer Rights Protection and Human Wellbeing) for the procurement of laboratory equipment in order to develop a sustainable system for the prevention, detection, and response to threats to the sanitary and epidemiological well-being of the population.

Read more

12

Nov 2020

In late October 2020, the BfArM (Federal Institute for Drugs and Medical Devices) has published the final version of the OPS 2021 (Operation and Procedure Keys) system. The OPS, together with the ICD-10-GM (International Statistical Classification of Diseases and Related Health Problems, 10th revision, German Modification), forms the basis for the reimbursement systems in outpatient and inpatient care.

Read more

28

Oct 2020

In mid-October 2020, the Federal Joint Committee (G-BA) has decided that three more biomarker-based tests in breast cancer will be covered by the statutory health insurance. Since January 2020, the "Oncotype DX Breast Recurrence Score" test is already reimbursed in Germany with a tariff of €3,296.50.

Read more

22

Oct 2020

The revised EBM (German Uniform Evaluation Standard) catalog for ambulatory reimbursement in Germany came into force on October 1, 2020. MTRC has compiled the selection of the most significant changes, concerning In-vitro diagnostics, telemedicine and vacuum wounds therapy.

Read more

12

Oct 2020

On September 30, 2020, the Dutch Healthcare Institute (Zorginstituut Nederland, ZIN) published the position that transcatheter aortic valve implantation (TAVI) in patients with aortic stenosis and a high risk of surgery is eligible for reimbursement under basic health insurance package.

Read more

08

Oct 2020

In September 2020, Swedish Medical Technologies Product (MTP) Council decided to evaluate gene diagnostics for breast cancer within the Orderly introduction framework. Swedish Dental and Pharmaceutical Benefits Agency (TLV) will perform health economic assessments of these tests, including MammaPrint, Oncotype DX, ProSigna, and EndoPredict

Read more

05

Oct 2020

In September 2020, the list of companion diagnostic tests, which are evaluated for reimbursement, was updated. INAMI has a specific reimbursement framework for companion diagnostic tests. INAMI Nomenclature codes from Article 33ter can only be reimbursed in relation to specific biomarker tests and drugs from Chapter VIII of the reimbursable pharmaceutical specialties (Royal Decree of February 1, 2018).

Read more

01

Oct 2020

On August 31, 2020, Decision Forum decided not to introduce blood-based tests in pregnant women with suspected pre-eclampsia that was evaluated within the New Method framework since 2018

Read more

25

Sep 2020

In late august 2020, the Basic Package Advisory Committee of the Dutch Health Care Institute (ZIN) concluded that Transcatheter Aortic Valve Implantation (TAVI) complies with the ‘state of the art and science’ and is therefore effective.

Read more

17

Sep 2020

On September 7, 2020, the Swiss Medical Board has announced that the organization will discontinue its operations at the end of 2021.

Read more

24

Aug 2020

The French National Authority for Health (HAS) released new decisions about add-on and medical aid reimbursement of many medical devices from the meetings of the National Commission for Evaluation of Medical Devices and Health Technologies (CNEDiMTS) in July 2020. Decisions concern drug-eluting coronary stents, TAVI, orthopedic appliances, wound dressing, stoma obturator, toric intraocular lens.

Read more

18

Aug 2020

On the 28th of July 2020, in the Official Journal of French Republic (JORF), an Order for the inclusion of the web application MOOVCARE POUMON intended for the medical telemonitoring of relapses and complications in patients with non-progressive lung cancer in the French List of Products and Healthcare Services Qualifying for Reimbursement (LPPR) was published. The application is already included in the LPPR list in section 1, “Materials and treatments in the home, dietary products, items for dressings,” chapter 1, section 7, and a specific sub-section 7, which has been created for web applications and software for remote monitoring.

Read more

14

Aug 2020

In July 2020, new subsidy options for medical aids care at home became available within the Dutch program Good use of care at home (GGH). By funding research, the GGH program stimulates knowledge development about the quality, safety, effectiveness, and efficiency of innovative medical aids care at home. The deadline for submitting applications is 6 October 2020.

Read more

03

Aug 2020

In June 2020, santésuisse (the leading organization of Swiss health insurers) and the Swiss Society of Surgeons (FCMH) have submitted a proposal to the Federal Council for the acceptance of 67 lump-sum payment packages for out-patient services. In July 2020, eight more lump-sum payment packages were suggested to the Federal Council. More suggestions are expected in the near future.

Read more

20

Jul 2020

In March 2020, the Dutch Healthcare Institute advised the Ministry of Health, Welfare, and Sport to simplify the reimbursement to diabetes care aids. In accordance with this advice, the Real-Time Continuous Glucose Monitoring (RT-CGM) and ketone test strips will no longer fall under specialist medical care (MSZ) but will be covered by medical aid care (HMZ). The new scheme is intended to take effect on 1 January 2021.

Read more

17

Jul 2020

The French High Authority for Health (HAS) develops national diagnostic and care protocols whose objective is to guarantee the quality and safety of care delivery within the French setting. In the first half of 2020, national diagnostic and care protocols have been developed for eighteen topics.

Read more

16

Jul 2020

The Corona warning app, developed on behalf of the German government, has been available for download in the Google and Apple stores since June 16, 2020. It is intended to help identify and break infection chains at an early stage. Users of the app receive a notification if they have been for a long time in the vicinity of a person who was later found to be infected with the coronavirus.

Read more

10

Jul 2020

On 22nd June 2020, the company in charge of the development of the DRG system in Switzerland, SwissDRG SA, has announced the catalog version of SwissDRG 10.0/2021 (2018/2021). Seven days later, the planning version of SwissDRG (2019/2021) has been published as well.

Read more

06

Jul 2020

The French High Authority for Health (HAS) regularly publishes new decisions about add-on reimbursement for medical devices. The decisions made in June 2020 concern various types of devices, including total lumbar disc prostheses, arthroscopic meniscal repair system, vagus nerve stimulation system, and medical aids. A total of 10 decisions were made.

Read more

01

Jul 2020

On 9 May 2020, the Reimbursement Commission made changes to the SUT regarding response to the COVID-19 pandemic and introduced codes for IVD tests for Covid-19 (SARS-CoV-2) reverse transcriptase PCR and detection of Covid-19 antigen, IgG, IgM.

Read more

26

Jun 2020

The reimbursement for PCR tests for the detection of SARS-CoV-2 will be reduced from €59.00 to €39.40 per test starting from July 1, 2020, and the billing of the examination will be limited to five times in the case of treatment. This decision was made by the extended evaluation committee on June 10, 2020.

Read more

24

Jun 2020

The Swiss cantons are required to jointly draw up a plan for the provision of highly specialized medical treatments (MHS). Until September 2020, the Conference of Cantonal Health Directors is discussing whether complex gynecological tumors, pediatric oncology, bariatric surgery, highly specialized pediatric surgery, and other areas of care should enter the MHS.

Read more

18

Jun 2020

According to the German Institute of Medical Documentation and Information (DIMDI) announcement, there will be a new ICD code for the coding of non-curative COVID-19 tests in symptom-free people implemented in ICD-10-GM on June 1, 2020. The implementation in the practice management systems is ongoing.

Read more

17

Jun 2020

On May 27, 2020, the Federal Council adopted the modification of the Insurance Law (KVG/LAMal) on the reimbursement of medical aids and equipment. In the future, health insurers will have to bear the costs of the medical material regardless of whether it is used directly by the insured person, by a non-professional person, or by the nursing staff.

Read more

15

Jun 2020

The French High Authority for Health (HAS) regularly publishes new decisions about add-on reimbursement for medical devices. The decisions made in May 2020 concern various types of devices, including cardiovascular devices (self-expanding intracranial stents, TAVI), CT navigation kit for CT-guided percutaneous interventions and medical aids. A total of 8 decisions were made.

Read more

03

Jun 2020

Public Health England has carried out a number of rapid evaluations of commercial serological tests for their suitability for detecting the production of COVID-19 antibodies. Abbott SARS-CoV-2 IgG assay and the Roche Elecsys Anti-SARS-CoV-2 serology assay were evaluated by Public Health England.

Read more

25

May 2020

MTRC has released the new video on the Market Access Insider Youtube channel. Oleg Borisenko spoke to Mr. Andrea Zanella, CEO of DIANAX S.r.l. about market access for in-vitro diagnostic tests in Italy.

Read more

21

May 2020

On May 7, 2020, the National Association of Statutory Health Insurance Physicians (KBV) announced that antibodies testing for COVID-19 will be reimbursement. The findings of the test must be communicated within 24 hours.

Read more

05

May 2020

In April 2020, the National Institute for Health and Care Excellence (NICE) published only one new medical technologies guidance (for PneuX to prevent ventilator-associated pneumonia) and two Medtech innovation briefings (for Lifelight First for monitoring vital signs and myCOPD for self-management of chronic obstructive pulmonary disease).

Read more

04

May 2020

The revised EBM (German Uniform Evaluation Standard) catalog came into force on April 1, 2020. MTRC has compiled the selection of the most significant changes.

Read more

03

Apr 2020

In March 2020, the entity managing the Swiss DRG system, SwissDRG, released several announcements about the changes related to the COVID19. The announcements concern diagnosis coding of COVID19, and the reimbursement changes required to adequately cover the care for the new disease.

Read more

02

Apr 2020

The report presents a summary of the reimbursement situation for mechanical ventilation in Europe. The following clinical indications are considered: acute community-acquired viral pneumonia complicated with acute respiratory failure; severe sepsis due to acute community-acquired viral pneumonia with multiorgan failure (cardiac, respiratory and renal); acute hemorrhagic stroke with the development of com. The analysis covers procedure coding, payment mechanism, reimbursement tariffs and policy restrictions in 11 EU countries including Austria, Belgium, Denmark, England, France, Germany, Italy, the Netherlands, Norway, Sweden and Switzerland. It is also possible to add analysis in the Czech Republic, Finland, Hungary, Romania, Russia and Turkey.

Read more

30

Mar 2020

On March 4, 2020, the List of Analyses (AL/EA) and the Services Ordinance (KLV/OPre) were updated in Switzerland. On April 1, 2020, the KLV/OPre, the AL/EA, and the List of Medical Aids (MiGel/EMAp) will be updated in Switzerland.

Read more

19

Mar 2020

On February 12, 2020, it was announced that the Swiss Federal Council is planning to modify the Health Insurance Ordinance (OAMal / KVV) with the goal of enhancing hospital planning, and unification of the inpatient tariffs throughout the country.

Read more

02

Mar 2020

On the 1st of February, 2020, the National Association of Statutory Health Insurance Physicians (KBV) and the National Association of Statutory Health Insurance Funds (GKV-SV) have made the agreement for laboratory diagnostic clarification about the novel coronavirus. Afterwards, the statutory health insurance companies will cover the costs of the test for the novel coronavirus (2019-nCoV) if there are justified suspected cases.

Read more

19

Feb 2020

On January 31, 2020, the non-statutory HTA body, Swiss Medical Board, published the results of the report in which they compared the surgical and non-surgical treatment of rotator cuff tears. Though the surgery is more effective, the traditional treatment demonstrated better cost-benefit results. Thus, the Swiss Medical Board recommends the rotator cuff surgery with limitations.

Read more

17

Feb 2020

The French High Authority for Health (HAS) regularly publishes new decisions about add-on reimbursement for medical devices. The decisions made in January 2020 concern various types of devices, mostly for cardiovascular and orthopaedic devices, and medial aids. A total of 29 decisions were made.

Read more

12

Feb 2020

At the end of January 2020, the entity managing the DRG system in Switzerland, SwissDRG, has published the data collection forms for SwissDRG 2020 (2019 data). Furthermore, an explanation about the coding of “Aortic stent graft (stent prosthesis)” has been released.

Read more

10

Feb 2020

We have released the interview on the Market Access Insider channel on Youtube. The interview covered key stakeholders, procedure coding, functioning of the DRG system, reimbursement processes for medical technologies in Switzerland. Michel discussed the biggest mistakes made by the Med Tech companies on the market and advised on the best strategy on how to approach the market.

Read more

04

Feb 2020

In January 2020, the Reimbursement Commission made changes to the Healthcare Implementation Communique in Turkey. The main changes relate to the addition of new laboratory test codes, procedure codes, new devices related to the ophthalmology, and price changing of materials related to interventional radiology.

Read more

30

Jan 2020

From January 2020, the "Oncotype DX Breast Recurrence Score" test is reimbursed by the health insurance companies at an extra budget of 3,296.50€. This is explicitly the only test that the Federal Joint Committee (G-BA) has included in the contracted medical care.

Read more

27

Jan 2020

The Swiss Services Ordinance (KLV/OPre) is the document that defines the health care services which are covered by the compulsory health insurance in Switzerland. It is updated annually (with more frequent updates possible); thus, the 2020 version is released. Changes concern autologous transplantation of chondrocytes, extracorporeal photopheresis, transcatheter aortic valve implantation, ultrasound therapy focused on the pallidum, thalamus and subthalamus, CAR-T cell therapies, tomography with positron emission (PET/CT), stereotactic radiation therapy (photons) of wet age-related macular degeneration.

Read more

20

Jan 2020

The French National Authority for Health (HAS) regularly publishes new decisions about add-on reimbursement for medical devices. The decisions made in December 2019 concern various types of devices, mostly for cardiovascular devices. A total of five decisions were made.

Read more

13

Jan 2020

In mid-December 2019, the Swiss Federal Department for Home Affairs (FDHA) has decided that two new autologous cell therapies (CAR-T therapies) for the treatment of leukemia and lymphoma will be reimbursed by compulsory health care insurance.

Read more

25

Dec 2019

In December 2019, the Swiss Medical Tariff Commission (MTK/CTM) has published their recommendations regarding the knee Autologous Chondrocyte Implantation (ACI). The CTM recommends covering the costs of the implant for knee ACI until the end of 2024.

Read more

20

Dec 2019

At the end of November 2019, the company in charge of the development of the DRG system in Switzerland, SwissDRG SA, has announced the tariff versions (2020/2020) of the DRG and the add-on reimbursement catalog.

Read more

19

Dec 2019

In late November 2019, new HTA activities were published on the website of regional HTA program of Lombardy Region, after a period of inactivity. Twenty-six (26) new technologies are currently in various stages of the HTA process, and they should all be completed in 2020.

Read more

16

Dec 2019

The French National Authority for Health (HAS) regularly publishes new decisions about add-on reimbursement for medical devices. The decisions made in November 2019 concern various types of devices, including orthopaedic, and cardiovascular devices. A total of twenty-four decisions were made.

Read more

11

Dec 2019

In October 2019, the Agency for Health Quality and Assessment of Catalonia (AQuAS) has released an assessment report regarding the evaluation strategies to prevent urinary tract infections associated with urethral/urinary catheters in critical patients in Intensive Care Units. The evidence is not conclusive, but there is scientific evidence that aims for the introduction of review measures for the indication of indwelling urethral/urinary catheters, its use in decubitus, and without kinking.

Read more

09

Dec 2019

In Sweden, the Centre for Assessment of Medical Technology (CAMTÖ) leads the development of HTA cooperation in the healthcare region Uppsala-Örebro. In September 2019, CAMTÖ released an HTA report on PD-L1 positivity tested by McAb SP263 to guide immune checkpoint therapy in non-small-cell lung cancer. No safe conclusions could be drawn, but the wide range of positivity rates implies the difficulties in the standardization of PD-L1 expression and the need for better predictive biomarkers.

Read more

04

Dec 2019

In November 2019, the two new mini-method assessments for ankyloglossia and rapid testing for chlamydia and gonorrhea were initiated by Oslo University. After the completion of the assessment procedure, the final reports would be available via a mini-HTA database.

Read more

11

Nov 2019

On the 19th of September 2019, the Federal Joint Committee (G-BA) concluded on the possible applications and limits of non-invasive molecular genetic tests (NIPT) at the expense of the statutory health insurance (SHI). The decision provides that a NIPT can be used in justified individual cases and after medical consultation.

Read more

25

Oct 2019

In Norway, the mini-HTA for intraepidermal nerve fiber density in skin biopsy was released in September 2019. The method was determined as efficient and safe. It was recommended to be introduced as part of the clinical routine in the hospital with a two-year follow-up to get enough data regarding the diagnostic volume and financial aspects.

Read more

17

Oct 2019

The insurance company AOK Saxony-Anhalt concluded that patients are much less frequently prescribed an antibiotic after the examination via a rapid test for a bacterial cause of the infection. In more than 40% of the tested patients, the doctors waived the antibiotics prescription.

Read more

10

Oct 2019

The fee negotiations for the coming year are over - the National Association of Statutory Health Insurance Physicians (KBV) and the National Association of Statutory Health Insurance Funds (GKV-Spitzenverband) agreed on an increase in the monetary conversion factor for all medical and psychotherapeutic services in the amount of 1.52 percent. GKV-Spitzenverband and KBV have also agreed to sponsor the video consultations.

Read more

03

Oct 2019

In order to diagnose pre-eclampsia in pregnancy, two new markers were included in the EBM catalog in early October 2019. The statutory health insurances then will take over the costs for the determination of the PIGF concentration and the sFlt-1 / PIGF quotient. In addition, another tumor marker for ovarian cancer will be included in the EBM.

Read more

27

Sep 2019

In August 2019, the Norwegian Institute of Public Health (NIPH) has released a single technology assessment report for molecular profiling panel – Prosigna aimed to investigate its prognostic accuracy, clinical and cost-effectiveness in patients with breast cancer. It was outlined that it is uncertain to what extent Prosigna contributes prognostic information that turns into better clinical results; conclusions about the cost-effectiveness of Prosigna cannot be made due to the lack of existing information.

Read more

25

Sep 2019

Within the framework of the Federal HTA program, the benefits currently paid under the compulsory health insurance are being reevaluated. On the 4th of September, 2019, the health technology assessment of arthroscopy of the knee, developed by the Swiss Medical Board on behalf of the Federal Ofice for Public Health, has been published.

Read more

20

Sep 2019

In mid-August 2019, the network of European HTA agencies, EUnetHTA, announced the final plan of the project OTCA22 “Clinical utility of Point-of-care Tests (POCT) D-Dimer and Troponin.”

Read more

06

Sep 2019

The seminar includes overview of topics of reimbursement, funding, payment mechanisms for IVD tests in hospital, day case and out-patient settings, health technology assessment, innovation funding, role of clinical and economic evidence, stakeholder engagement. Data from 10 EU countries are used. The seminar is available as a pre-recorded on-demand webinar or full presentation in Acrobat PDF.

Read more

04

Sep 2019

Laboratory examinations that can predict whether a patient will receive therapeutic benefits from “personalized” drug treatment or from so-called "molecular companions diagnostics" can be promptly and flexibly reimbursed using the new specific procedure from July 1, 2019.

Read more

02

Sep 2019

On July 31, 2019, the Swiss Federal Statistics Office (UFS) has published the list of CHOP procedure codes, version 2020, which are used for procedure coding and in the DRG system for reimbursement of hospistal services.

Read more

30

Aug 2019

Technical overviews include details of application processes for procedure codes and payments (e.g. DRG), inclusion into health benefit catalogs. Overviews are available as presentations in Acrobat PDF.

Read more

30

Aug 2019

Educational modules include an overview of key stakeholders, money flow, payment model for IVD tests in the ambulatory sector, the process of creation of reimbursement for novel IVD tests. Overviews are available for France, Germany, Italy, Switzerland. Overviews are available as presentations in Acrobat PDF.

Read more

30

Aug 2019

In late July 2019, the report of the project OTJA10, titled “Stool DNA testing for early detection of colorectal cancer” was published on the website of the European Network for HTA (EUnetHTA).

Read more

22

Aug 2019

With the preventive program for pregnant women, "Hello Baby," premature births and infection-related birth complications should be minimized. Now, the program has been established nationwide: 60 health insurance companies offer to their approximately 6.5 million insured since July 1, 2019, the additional tests contained therein.

Read more

19

Aug 2019

Explanation about the coding of selective intravascular radiotherapy (SIRT) with microspheres labeled with holmium-166, and of creation of intracardiac septal defect with implantation of an interauricular implant (percutaneous transluminal) in Switzerland was released by SwissDRG on July 26, and July 31, 2019, respectively.

Read more

16

Aug 2019

The HTA center of Swedish Västra Götaland region has published a report for gene expression profiles to guide adjuvant chemotherapy in luminal, HER2-negative breast cancer. It was concluded that withholding adjuvant chemotherapy in breast cancer patients with intermediate clinical risk of recurrence and low/intermediate risk according to a gene expression assay, compared with providing chemotherapy, probably results in little or no difference in overall survival within nine years and can probably not exclude a small increased risk of recurrence.

Read more

01

Aug 2019

Predictive Analysis for Therapy (PATH) is a major collaborative project to optimize molecular predictive diagnostics in the Netherlands. The project focuses on the molecular analyses that are important for the treatment choice of cancer patients.

Read more

26

Jul 2019

On July 12, 2019, the Swiss Medical Tariff Commission (MTK/CTM), announced that the new tariff structure for the ambulatory sector, TARDOC, is ready to replace TARMED. The Medical Professional Association (FMH) and curafutura, the other involved partners, delivered TARDOC to the Federal Council for approval. The entry into force is scheduled for January 1, 2021.

Read more

19

Jul 2019

In June 2019, the Dental and Pharmaceutical Benefits Agency (TLV) has published a completed health economic evaluation regarding the cost-effectiveness of the comprehensive genomic profiling test for all solid tumors FoundationOne CDx. TLV believes that in most cases, the use of FoundationOne CDx is more expensive in comparison to current treatment methods. However, it has greater sensitivity and accuracy in the diagnostics.

Read more

18

Jul 2019

In late June 2019, the Federal Joint Committee (G-BA) took its first decision on the use of biomarker-based tests. Patients with breast cancer in the early stages, in which the risk of relapse cannot be determined with certainty, can be provided in the future with a biomarker test as a statutory health insurance (SHI) benefit.

Read more

17

Jul 2019

On June 6, 2019, the Swiss Federal Department of Home Affairs (FDHA) has changed the Services Ordinance (OPre/KLV), which determines coverage of health care services in Switzerland. The changes regard mostly the reimbursement rules for various services. Furthermore, there are updates regarding the Health Insurance Law (LAMal/KVG), List of Analyses, List of Medical Aids and Equipment, and clinical coding.

Read more

16

Jul 2019

In June 2019, the Norwegian Institute of Public Health (NIPH) has released an HTA report for TAVI in patients with severe aortic stenosis and intermediate surgical risk commissioned by the National System for Managed Introduction of New Health Technologies within the Specialist Health Service in Norway. The cost-utility analysis indicated that TAVI was slightly more effective and more costly than open surgery. These findings can help decision makers appraise the intervention against the official priority setting criteria in health care sector applicable in Norway.

Read more

11

Jul 2019

On 17th June 2019, the company in charge of the development of the DRG system in Switzerland, SwissDRG SA, has announced the catalog version of SwissDRG 9.0/2020 (2017/2020). Eleven days later, the planning version of SwissDRG (2018/2020) has been published as well.

Read more

25

Jun 2019

In Norway, the mini-HTA for above cuff vocalization for patients, who are not able to speak due to tracheostomy, was released in June 2019. The method was determined as efficient, safe, and was recommended to be introduced as part of the clinical routine in the hospital with further monitoring.

Read more

31

May 2019

Between the 3rd of June and the 15th of July, SwissDRG will be receiving the requests/suggestions regarding the DRG system in the country.

Read more

29

May 2019

In April 2019, the Ministry of Health, Consumption and Social Welfare announced the update of the common package of benefits of the Spanish national health system with the inclusion of cervical cancer screening, nipple and areola micropigmentation and update of orthoprosthesis catalog.

Read more

29

May 2019

The report includes all published reimbursement decisions for IVD tests in 2018 in European countries with established frameworks for out-patient reimbursement laboratory tests (Belgium, France, Germany, Netherlands, Switzerland).

Read more

28

May 2019

The report includes an overview of funding framework and all (as of May 2019) decisions from ultimate payers and decisions makers in England (NHS England, one CCG), Germany (G-BA), Netherlands (Zorginstituut Nederland), Norway (“New Methods” framework) and Switzerland (Federal Office of Public Health). More than 1000 decisions are included.

Read more

24

May 2019

At the end of April 2019, the network of European HTA agencies, EUnetHTA, published the “Custom-made or customizable 3D printed implants and cutting guides versus non-3D printed standard implants and cutting guides for improving outcome in patients undergoing knee, maxillofacial, or cranial surgery.”

Read more

20

May 2019

With the regional decree of April 23, 2019, Tuscany Regional Healthcare has published assessments of six medical devices belonging to various therapeutic areas, including a system for monitoring in heart failure, TAVI, glaucoma drainage system, intravascular lithotripsy system.

Read more

14

May 2019

The report presents a summary of reimbursement situation for use of Embolic Protection Devices during percutaneous cardiac procedures (PCI and TAVI). The analysis covers procedure coding, payment mechanism, reimbursement tariffs and policy restrictions in 11 EU countries including Austria, Belgium, Denmark, England, France, Germany, Italy, the Netherlands, Norway, Sweden and Switzerland.

Read more

08

May 2019

In 2013, Norway established a framework “New Method” for the introduction of innovations into the health care system through either a national or hospital-based health technology assessment. In this framework, all innovations should undergo HTA before being funded. In April of 2019, the new mini-HTA regarding above cuff vocalization (ACV) was initiated by Oslo University Hospital. After completion of the assessment, hospital management will make a decision about funding of studied technology.

Read more

25

Apr 2019

The Swiss innovation agency, InnoSuisse, reminds that the deadline for the application for financing of truly innovative projects is May 20, 2019. The Swiss Federal Council has ensured additional funding of CHF 24 million for 2019 and 2020 for the “Impulse digitalization programme.”

Read more

19

Apr 2019

In Finland, the Health Care Services Selection Council is responsible for making recommendations regarding the research, treatment and rehabilitation methods. Currently, PALKO is working on the only one assessment related to in-vitro diagnostics - screening for a Serious Combined Immune Deficiency (SCID) from newborn heel. In final report, the Council will conclude whether the procedure is a part of publicly funded services or not.

Read more

11

Apr 2019

On March 15, 2019, the Swiss Medical Board published two appraisal reports: “Robot-assisted laparoscopic surgery versus open surgery for radical prostatectomy” and “Robot-assisted laparoscopic surgery versus conventional laparoscopic surgery for simple or radical hysterectomy.”

Read more

20

Mar 2019

On February 19, 2019 the new “Catalog of Goods and Services” for the centralized purchasing platform was presented to the regional health authorities by the Minister of Health. This new catalog includes up to 25,000 items, including drugs and health products.

Read more

19

Mar 2019

In February 2019, the entity that is in charge of the DRG system in Switzerland, SwissDRG, announced the publication dates of the SwissDRG 9.0/2020 catalog, but also information that concerns the suggestions regarding SwissDRG.

Read more

15

Mar 2019

In mid-February 2019, the Swiss conference of cantonal healthcare directors (GDK/CDS) has published information about allocation of hospitals for highly complex visceral surgery in the fields of oesophageal, pancreatic and hepatic resections.

Read more

11

Mar 2019

On February 5, 2019, the Federal Department of Home Affairs (FDHA) decided that in case of suspected infection or fever of unknown origin, positron emission tomography (TEP) will be considered mandatory services. Also, percutaneous electrical stimulation of the posterior tibial nerve (PTNS) was approved for incontinence indication. Furthermore, the reimbursement amounts relating to incontinence and ostomy materials will be reduced. List of Analyses was also updated.

Read more

01

Mar 2019

Eleven new DRGs have been added in 2019, while three DRGs have been deleted. The significant changes have been made for disorders of the circulatory organs (MDC 5) and musculoskeletal, skeletal and connective tissue disorders associated with prosthetic surgery (MDC 8). They concern insertion of vagus stimulator, ablation of heart, percutaneous valve replacement, and others.

Read more

20

Feb 2019

On January 31st, 2019, the French High Authority for Health (HAS) has published a new assessment of transcatheter aortic valve implantation (TAVI). The objective of this assessment was to clarify the level of requirements of the National Commission for the Evaluation of Medical Devices and Health Technologies (CNEDiMTS) in terms of minimal clinical data to provide for the registration of a new TAVI on the LPPR, for the acceptance of a new indication for a TAVI already registered on the LPPR and for renewal of registration of a TAVI registered on the LPPR.

Read more

13

Feb 2019

In January 2019, the Ministry of Health, Consumer Affairs and Social Wellbeing of Spain has released an Order by which Annex VI of the Royal Decree 1030/2006 was modified. With this modification, the common catalog of ortho-prosthetic devices is updated with new products (wheelchairs, orthoses and special prosthetics).

Read more

06

Feb 2019

The French National Authority for Health (HAS) released new decisions about add-on and medical aid reimbursement of medical devices from the meetings of the National Commission for Evaluation of Medical Devices and Health Technologies (CNEDiMTS) in January 2019. The decisions were made for eighteen medical devices.

Read more

21

Jan 2019

Curafutura, an association of health insurance companies in Switzerland, started the initiative to change the current outpatient pricing structure (TARMED) in 2016. In late 2018, they let the public know that the new tariff structure for ambulatory medical benefits is almost ready to be submitted to the Federal Council.

Read more

17

Jan 2019

In late December 2018, the European HTA agency, EUnetHTA, announced the final report of the project OTCA06 - “Transcatheter aortic valve implantation (TAVI) in patients at intermediate surgical risk.”

Read more

16

Jan 2019

The Federal Statistics Office has published, in late December 2018, the changes regarding procedure coding that would come into force in January 2019. The changes concern CAR-T cell therapy and intervertebral arthrodesis devices, among other treatment methods. Besides the changes implemented, the list of all requested changes in 2018 was published.

Read more

11

Jan 2019

Federal Department of Home Affairs (FDHA) released changes in coverage of medical procedures, IVD tests and medical aids in Switzerland. They include extension of coverage for neonatal screening to severe congenital immunodeficiencies, extension of coverage under restrictions for TAVI, gene test for breast cancer, PET, PET / CT, local superficial hyperthermia during tumour treatment, external defibrillator and coverage for sub-urethral tapes for the treatment of stress urinary incontinence in women. Also, changes in the coverage for neonatal screening were introduced.

Read more

08

Jan 2019

On December 14, 2018, the Center of Competence and Coordination of Confederation and Cantons, Swiss eHealth, has published version 2.0 of the Swiss eHealth strategy. This version replaces the 2007 version and will be applied until 2022. With the "Swiss eHealth Strategy 2.0", the Confederation and the cantons intend to enhance the promotion of digitalization in the healthcare sector, whose priority is the introduction and dissemination of the patient's digital record.

Read more

07

Jan 2019

The French National Authority for Health (HAS) regularly publishes new decisions about add-on reimbursement for medical devices. The decisions made in December 2018 concern various types of devices (orthopedic, neurostimulators, drug-coated balloon and others). The decisions were brought for ten (10) medical devices.

Read more

03

Jan 2019

On November 30, 2018, the DRG-regulating body in Switzerland, SwissDRG, has notified the public that the tariff version of SwissDRG 8.0/2019 has been published.

Read more

11

Dec 2018

On November 15, 2018, the Swiss Federal Statistics Office (UFS) has notified the public that the CHOP version 2019 and ICD-10-GM version 2018 were published.

Read more

03

Dec 2018

On 13th of November, 2018, one of the Swiss insurers’ association, curafutura, announced on their website that the new benefit structure, which will be the basis for the new fee structure in ambulatory settings, is ready. The company ats-tms SA prepared this benefit structure.

Read more

25

Oct 2018

In mid-September 2018, the Swiss Federal Council has placed in consultation the first group of actions that are intended to contain costs in the healthcare sector. The suggested measures will be discussed with all relevant healthcare stakeholders (tariff partners, Cantons, industry and patient associations). These measures should save hundreds of millions of Swiss francs in the long term.

Read more

23

Oct 2018

Explanation about the coding of CAR-T cell therapy in Switzerland was released by SwissDRG.

Read more

16

Oct 2018

The board of directors of the entity that runs and manages the Swiss DRG system, SwissDRG SA, decided to verify the conditions necessary for the foundation of the outpatient tariff agency in late September 2018.

Read more

08

Oct 2018

On the 3rd of September 2018, an association of 4 Swiss health insurers, curafutura, published their opinion on the proposed reform of payment mechanism for inpatient and outpatient services.

Read more

04

Oct 2018

On 13th of August, 2018, the association of Swiss insurers, santésuisse, published an announcement in which they state that the control of the invoices received saves the premium payers’ costs up to CHF 3 billion.

Read more

02

Oct 2018

On 24th of August, 2018, the company that maintains DRG system in Switzerland, SwissDRG SA, has announced that the planning version of SwissDRG (version 8.0 (2018/2019)) and the planning version of TARPSY (version 2.0 (2018/2019)) have been published.

Read more

12

Sep 2018

Clarifications about coding of CytoSorb procedure and use of Flow Diverter in Switzerland were released by SwissDRG.

Read more

04

Sep 2018

At the end of June of 2018, the National Board of Health and Welfare (Socialtyrelsen) has published an updated version of the National clinical guidelines for heart care. The review was conducted for the inclusion of few updated recommendations regarding the management of the coronary heart disease, valvulopathy and arrhythmia.

Read more

15

Aug 2018

At the beginning of July 2018, the Swiss agency for therapeutic products, Swissmedic, has released an announcement about the upcoming changes about upcoming changes relating to the issuing of Export Certificates (FSC) and Manufacturing Certificates (MC).

Read more

10

Aug 2018

In April 2018, a national HTA program has been launched in order to re-evaluate benefits presently covered by the mandatory health insurance.

Read more

09

Aug 2018

On June 29th, 2018, the company that maintains DRG system in Switzerland, SwissDRG SA, has announced that The planning version of SwissDRG (version 8.0 (2017/2019)) and the planning version of TARPSY (version 2.0 (2017/2019)) have been published.

Read more

26

Jul 2018

At the beginning of June 2018, the Federal Department of Home Affairs published an update of the Services Ordinance (Ordinanza sulle prestazioni, OPre). This update concerns many different fields, including the list of laboratory tests.

Read more

24

Jul 2018

On 8th of June 2018, the company in charge of the development of the DRG system in Switzerland, SwissDRG SA, has announced the catalogue version of Swiss DRG 8.0/2019.

Read more

20

Jul 2018

On 18th of June, 2018, the Federal Department of Home Affairs issued the latest update of the list of medical aids and equipment. This update will come into force on 1st of January, 2019. However, this list will be updated a few times in 2018.

Read more

16

Jul 2018

Starting with 19th of June, 2018, HIV self-test kits can be bought in pharmacies and druggists all over Switzerland.

Read more

04

Jul 2018

A change in the Services Order (Ordinanza sulle Prestazioni, OPre), regarding surgery in general, will come into force on January 1st, 2019. This change makes it possible to reimburse a number of surgeries in hospital settings in exceptional circumstances because in general, these procedures should be performed in out-patient settings.

Read more

20

Jun 2018

On 28th of May, 2018, the Swiss Medical Tariff Commission (CTM-MTK) has agreed with the hospitals association (H+) on a transitional solution for the application of TARMED, which will last until July 31st, 2018.

Read more

13

Jun 2018

The list of the laboratory tests is based on the Services Order (Ordinanza sulle Prestazioni, OPre) of the September 29th, 1995; the latest update is in force since January 1st, 2018. The list contains the services whose costs are covered by the obligatory healthcare insurance (assicurazione obbligatoria delle cure medico-sanitarie, AOMS). With the latest update, there are 1931 tests on this list.
See the list of the January 2018 modifications in Italian here.
See the full list of current laboratory tests in Excel format (in French, German and Italian) here.
Subscribe to our newsletter delivered every second week not to miss important reimbursement information.

Read more

11

Jun 2018

On 11th May, the Italian Ministry of Health announced from its website that five new Med Tech-related HTA documents are available for public consultation. See the details in the MTRC post.

Read more

01

Jun 2018

European Med Tech and IVD Reimbursement Consulting Ltd. released a report, which identifies and provides an overview of the innovative payment schemes for medical devices and in-vitro diagnostic tests in European countries. The report was supported by the grant from the Med Tech Europe. Access the full version of the report at our web-site.

Read more

16

May 2018

National Institute for Sickness and Disability Insurance (RIZIV/INAMI) reimburses some or all of the non-implantable medical devices provided by the pharmacist or in some cases by a supplier. In May 2018 the list of non-implantable medical devices has been updated.

Read more

10

May 2018

Between 28th of May and 9th of July 2018, SwissDRG will be accepting the requests/suggestions regarding the DRG system in the country.

Read more

20

Apr 2018

On 5th of April, 2018, the Board of Directors of SwissDRG SA has given the director the mandate to establish, where appropriate, codifications by analogy in agreement with the Federal Statistics Office (FSO). The regulation from April of 2018 covers CytoSorb for removal of cytokines.

Read more

16

Apr 2018

In February 2018, the DFI (the Federal Department of Home Affairs) has decided to make a change in the activity order (Ordinanza sulle prestazioni, OPre) concerning “out-patient before in-patient.” The modification is coming into force starting January 1st, 2019. Six procedures will be reimbursed only in out-patient settings.

Read more

15

Mar 2018

The German Federal Joint Committee (G-BA) has commissioned the Institute for Quality Assurance and Transparency in Health Care (IQTIG) to evaluate the guideline on minimally invasive heart valve interventions with minimum quality standards for hospitals that want to perform transcatheter aortic valve implantation (TAVI) or clip procedures on the mitral valve. The report has to be submitted by December, 2019.

Read more

10

Jan 2018

The Department of Home Affairs (EDI) in Switzerland decided upon the coverage with evidence development (CED) of two types of positron emission tomography as well as stereotactic radiotherapy (photons) of exudative age-related macular degeneration. The status is given to contested medical services for a specific period which is extended until evidence is complete.

Read more

05

Jan 2018

The generic quality framework and three modules of care describe the general requirements for medical devices for home-based application, included in the Health Insurance Act (Zvw). This framework is not intended for medical devices that fall under the Social Support Act (Wmo) and medical aids provided in intramural settings.

Read more

27

Dec 2017

The further-developed tariff structure SwissDRG was approved by the Federal Council in Switzerland. The new tariff version for inpatient services will be effective from January 1st in 2018. The tariff structure SwissDRG defines how inpatient services in the acute care area of the hospitals and birthplaces are reimbursed within the framework of compulsory health care insurance in Switzerland.

Read more

27

Nov 2017

EUnetHTA has published project plan of rapid assessment of TAVI procedure in patients with intermediate risk. Current plan describes the design and methodology of the assessment, list of involved reviewers, stakeholders and timelines of the project. The final report will be prepared till the end of January 2018.

Read more

22

Nov 2017

The Austrian HTA body LBI-HTA performed a systematic review of health economic evaluations of Transcatheter Aortic Valve Implantation (TAVI) compared to medical treatment and surgical aortic valve replacement for inoperable and operable patients with high or moderate surgical risk. The result of the review have only limited transferability to Austria, and LBI-HTA concluded, that the currently applied selection of patients based on clinical parameters can be considered as good practice.

Read more

20

Nov 2017

Annual report from the Italian Society of Interventional Cardiology (GISE) shows increasing trends in procedural volume of percutaneous coronary interventions (PCI), transcatheter aortic valve implantations (TAVI), mitral clip implantations, closure of left atrial appendage (LAA) and patent foramen ovale (PFO).

Read more

08

Nov 2017

An international advisor group of 14 medical and health economic experts proposed 38 measures of how control the increase of healthcare costs in Switzerland. One third of the actions including the strengthening of HTA are already considered. The Swiss Federal Council now wants to develop concrete plans for the implementation of the new measures suggested in the report by the expert group, including global budgets for the outpatient sector, the introduction of medical boards, the encouragement of parallel imports of medical technology and implants and annual review of prices.

Read more

03

Nov 2017

In October, HAS published a set of decisions about add-on reimbursement of medical devices that were assessed by the National Commission for Evaluation of Medical Devices and Health Technologies (CNEDiMTS). These decisions concern orthopedic devices (foot prosthesis, bone graft substitute), TAVI using Sapien valve, liquid embolic system, remote monitoring system, wound dressing and home oxygen system.

Read more

16

Aug 2017

In the second two weeks of July, the National Institute for Health and Care Excellence published one new (FebriDx for C-reactive protein and Myxovirus resistance protein A testing in primary care) and 3 updated Medtech Innovation Briefings, new Diagnostics Guidance for quantitative faecal immunochemical tests to guide referral for colorectal cancer in primary care and three new Interventional Procedures Guidance for laparoscopic insertion of a magnetic titanium ring for gastro-oesophageal reflux disease, transcatheter aortic valve implantation for aortic stenosis and hysteroscopic sterilisation by insertion of intrafallopian implants.

Read more

25

Jul 2017

SwissDRG has released overview of planned update of DRG system (version 7.0) in 2018, including list of preliminary approved add-on reimbursement categories. Add-on will be established for endobronchial valves, proton therapy, autologous matrix-induced chondrocyte implantation at knee joint and intermitted hemodialysis for removal of proteins with molecular mass up to 60,000 Da.

Read more

21

Apr 2017

SwissDRG has released the application form for suggestions for DRG change in 2017. Applications will be collected between 29th of May and 10th of July 2017. Approved changes will be implemented in 2019.

Read more

04

Apr 2017

NICE in the UK has released a consultation document in relation to the TAVI procedure (Interventional Procedure Guidance). Publication of the final guidance, which will replace the guidance from the 2012, is expected in July 2017.

Read more

30

Mar 2017

Our analysis of creation of procedure codes for TAVI in 11 European markets shows different speed in creation of codes, but in general it was a quick process (1.8 years on average). However, in all markets, availability of procedure code did not automatically lead to reimbursement or appropriate reimbursement.

Read more

20

Mar 2017

MTRC has released reimbursement report for transcatheter aortic valve implantation in 11 European countries. Report includes information about procedure coding, payment mechanisms, reimbursement tariffs and policies for TAVI.

Read more

15

Mar 2017

MTRC is working on release of 9 reimbursement reports for medical technologies during March 2017, including report for transcatheter aortic valve replacement and eight minimally invasive mitral valve repair and replacement procedures.

Read more