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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 coverage decisions in Switzerland

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.

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